Proton Pump Inhibitors: The Good, the Bad, and the Unwanted

From the Department of Gastroenterology, University of Connecticut, Farmington.
Southern medical journal (Impact Factor: 0.93). 11/2012; 105(11):613-8. DOI: 10.1097/SMJ.0b013e31826efbea
Source: PubMed


Proton pump inhibitors (PPIs) are one of the most commonly prescribed classes of medications in the United States. By inhibiting gastric H/K adenosine triphosphatase via covalent binding to the cysteine residues of the proton pump, they provide the most potent acid suppression available. Long-term PPI use accounts for the majority of total PPI use. Absolute indications include peptic ulcer disease, chronic nonsteroidal anti-inflammatory drugs use, treatment of Helicobacter pylori, and erosive esophagitis. Although PPIs are generally considered safe, numerous adverse effects, particularly associated with long-term use have been reported. Many patients receiving chronic PPI therapy do not have clear indications for their use, prompting consideration for reduction or discontinuation of their use. This article reviews the indications for PPI use, the adverse effects/risks involved with their use, and conditions in which their use is controversial.

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    • "The treatment of gastric ulcers aims the inhibition of gastric acid secretion, using H 2 receptors antagonists and proton-pump inhibitors (PPIs) (Cryer and Mahaffey 2014). However, long-term acid suppressive therapy is associated to several side effects, and the gastric acid inhibition or Helicobacter pylori eradication during ulcer healing were not sufficient to avoid the gastric ulcer recurrence (Chubineh and Birk 2012; DeVault and Talley 2009, Kangwan et al. 2014). For this reason, the interest in natural products has increased due to efficacy and fewer side effects, becoming a potential source for antiulcer treatment. "
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