Proton Pump Inhibitors

Proton pump inhibitor (PPI) is a class of medication that reduces the production of stomach acid.  They’re prescribed or recommended in over-the-counter (OTC) form to patients with acid reflux, nausea, and other conditions including extra stomach acid.  PPIs may have serious side effects, particularly with long-term use which could result in nutrient deficiencies due to malabsorption leading to complications like severe kidney illness and bone fracture.

Proton Pump Inhibitors and Their Uses

PPIs are available in prescription and OTC form. Examples of PPI drugs include:

  • Prilosec (omeprazole)
  • Prevacid (lansoprazole)
  • Nexium (esomeprazole)
  • AcipHex (rabeprazole)
  • Protonix (pantoprazole)
  • Dexilant (dexlansoprazole)

PPI uses include:

  • Relieving symptoms of gastroesophageal reflux disease (GERD), also known as acid reflux
  • Healing damage to the esophagus caused by GERD
  • Heal peptic ulcers
  • Eradication of H. pylori when used in combination of antibiotics
  • Treatment of Barrett’s esophagus

Proton Pump Inhibitor Side Effects

Common PPI side effects include:

  • Headache
  • Rash
  • Nausea
  • Diarrhea
  • Constipation
  • Abdominal pain
  • Flatulence

Long-term use of PPI medication is discouraged because lack of stomach acid may lead to malabsorption, resulting in nutritional deficiencies, and compromises the immune system. However, discontinuing PPIs can be challenging for most patients because of the rebound in acid levels.  PPIs can lead to malabsorption of magnesium, calcium, B12, and iron.

PPI use has been associated with increased risk of:

  • Heart attack
  • Pneumonia
  • Clostridium difficile infection
  • Hip, wrist, and spinal fractures
  • Kidney problems
  • Dementia

Kidney Problems Linked to Proton Pump Inhibitors

Recent studies have found an increased rate of kidney disease in PPI users.  A research published in JAMA Internal Medicine, in January, 2016, discovered that PPI use was linked with a 20% to 50 percent greater risk of chronic kidney disease.  The analysis followed 10,482 individuals for an average of 13.9 years.  It compared PPI users to those who used histamine 2 receptor antagonists (H2 blockers) and also to patients who did not use heartburn drugs.

Another study, published in the Journal of the American Society of Nephrology, in April, 2016, found an increased risk of developing new chronic kidney disease, progression of kidney disease, and kidney failure.

This research looked at Veterans Administration databases, identifying 173,321 brand new PPI consumers and 20,270 brand new H2 blocker customers.  Over the course of five years, the PPI users had a 28 percent higher chance of developing chronic kidney disease and double the probability of end-stage kidney failure when compared with H2 blocker users.  Researchers also discovered that more use of PPIs improved the risk with people using PPIs for a few years being three times as likely to experience kidney failure compared to individuals using PPIs for a single month or even less.

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