Proton pump inhibitors (PPIs) are a group of drugs whose purpose it is to reduce stomach acid. They have been used to treat a wide of gastric acid-related illnesses for more than 30 years and are known to be safe and effective—so much so that they’ve largely supplanted H2 blockers as the drug of choice.
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This is not to say that PPIs aren’t without their challenges or limitations. While most of the side effects are mild and manageable, there are a number of adverse events which can occur with long-term use or overuse. These include problems with the absorption of minerals, changes in bone density, and an increased risk for certain chronic illnesses.
How Proton Pump Inhibitors Work
Proton pump inhibitors are commonly used to treat disorders likegastroesophageal reflux disease (GERD),peptic ulcers, anderosive esophagitis. Healthcare providers may prescribe using PPIs alone or in combination with antacids.They can also be usedin combination with certain antibioticswhen treating Helicobacter pylori (a bacteria commonly associated with recurring stomach ulcers).
Types of Proton Pump Inhibitors
Generally speaking, one PPI doesn’t differ all that much from others. They all have similar mechanisms of action and similar rates of effectiveness. Currently approved PPIs include:
It’s important to speak with your healthcare provider to ensure that the use of a PPI is appropriate.
Side Effects and Interactions
When taken over the short term, most of the side effects associated with PPI use are mild and transient. The most common include constipation, diarrhea, flatulence, headache,upset stomach, nausea, and vomiting.
Increasing evidence suggests that long-term use may result in more serious problems. Among them:
Many of these adverse effects appear connected to the fact thatPPIsnot only turn off acid pumps in the stomach but in the rest of the body, as well. This includes the part of a cell called the lysosome which uses acid to clear waste. Without the means to do so, the waste can accumulate and cause the cell to deteriorate and age. This phenomenon may account for the increases seen in the studies.
11 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Harvard Health Publishing, Harvard Medical School.Proton-pump inhibitors.Harvard Health Publishing, Harvard Medical School.Do PPIs have long-term side effects?Ali khan M, Howden CW.The role of proton pump inhibitors in the management of upper gastrointestinal disorders.Gastroenterol Hepatol (N Y); 14(3):169-175.Masaoka T, Suzuki H, Hibi T.Gastric epithelial cell modality and proton pump inhibitor.J Clin Biochem Nutr. 2008;42(3):191-6. doi:10.3164/jcbn.2008028Open Anesthesia. The International Anesthesia Research Society.H2-blockers: onset time.International Foundation for Gastrointestinal Disorders, Inc.Proton pump inhibitors (PPIs), questions and answers about PPIs.National Health Services.Omeprazole.U.S. Food & Drug Administration.FDA drug safety communication: possible increased risk of fractures of the hip, wrist, and spine with the use of proton pump inhibitors.Lazarus B, Chen Y, Wilson FP, et al.Proton pump inhibitor use and the risk of chronic kidney disease.JAMA Intern Med. 2016;176(2):238-46. doi:10.1001/jamainternmed.2015.7193Lehault WB, Hughes DM.Review of the long-term effects of proton pump inhibitors.Fed Pract; 34(2):19-23.Yepuri G, Sukhovershin R, Nazari-shafti TZ, Petrascheck M, Ghebre YT, Cooke JP.Proton pump inhibitors accelerate endothelial senescence.Circ Res. 2016;118(12):e36-42. doi:10.1161/CIRCRESAHA.116.308807Additional ReadingJacob Schoenfeld, J. and Grady, D. “Adverse Effects Associated With Proton Pump Inhibitors.“Journal of the American Medical Association: 176(2):172-174.
11 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Harvard Health Publishing, Harvard Medical School.Proton-pump inhibitors.Harvard Health Publishing, Harvard Medical School.Do PPIs have long-term side effects?Ali khan M, Howden CW.The role of proton pump inhibitors in the management of upper gastrointestinal disorders.Gastroenterol Hepatol (N Y); 14(3):169-175.Masaoka T, Suzuki H, Hibi T.Gastric epithelial cell modality and proton pump inhibitor.J Clin Biochem Nutr. 2008;42(3):191-6. doi:10.3164/jcbn.2008028Open Anesthesia. The International Anesthesia Research Society.H2-blockers: onset time.International Foundation for Gastrointestinal Disorders, Inc.Proton pump inhibitors (PPIs), questions and answers about PPIs.National Health Services.Omeprazole.U.S. Food & Drug Administration.FDA drug safety communication: possible increased risk of fractures of the hip, wrist, and spine with the use of proton pump inhibitors.Lazarus B, Chen Y, Wilson FP, et al.Proton pump inhibitor use and the risk of chronic kidney disease.JAMA Intern Med. 2016;176(2):238-46. doi:10.1001/jamainternmed.2015.7193Lehault WB, Hughes DM.Review of the long-term effects of proton pump inhibitors.Fed Pract; 34(2):19-23.Yepuri G, Sukhovershin R, Nazari-shafti TZ, Petrascheck M, Ghebre YT, Cooke JP.Proton pump inhibitors accelerate endothelial senescence.Circ Res. 2016;118(12):e36-42. doi:10.1161/CIRCRESAHA.116.308807Additional ReadingJacob Schoenfeld, J. and Grady, D. “Adverse Effects Associated With Proton Pump Inhibitors.“Journal of the American Medical Association: 176(2):172-174.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Harvard Health Publishing, Harvard Medical School.Proton-pump inhibitors.Harvard Health Publishing, Harvard Medical School.Do PPIs have long-term side effects?Ali khan M, Howden CW.The role of proton pump inhibitors in the management of upper gastrointestinal disorders.Gastroenterol Hepatol (N Y); 14(3):169-175.Masaoka T, Suzuki H, Hibi T.Gastric epithelial cell modality and proton pump inhibitor.J Clin Biochem Nutr. 2008;42(3):191-6. doi:10.3164/jcbn.2008028Open Anesthesia. The International Anesthesia Research Society.H2-blockers: onset time.International Foundation for Gastrointestinal Disorders, Inc.Proton pump inhibitors (PPIs), questions and answers about PPIs.National Health Services.Omeprazole.U.S. Food & Drug Administration.FDA drug safety communication: possible increased risk of fractures of the hip, wrist, and spine with the use of proton pump inhibitors.Lazarus B, Chen Y, Wilson FP, et al.Proton pump inhibitor use and the risk of chronic kidney disease.JAMA Intern Med. 2016;176(2):238-46. doi:10.1001/jamainternmed.2015.7193Lehault WB, Hughes DM.Review of the long-term effects of proton pump inhibitors.Fed Pract; 34(2):19-23.Yepuri G, Sukhovershin R, Nazari-shafti TZ, Petrascheck M, Ghebre YT, Cooke JP.Proton pump inhibitors accelerate endothelial senescence.Circ Res. 2016;118(12):e36-42. doi:10.1161/CIRCRESAHA.116.308807
Harvard Health Publishing, Harvard Medical School.Proton-pump inhibitors.
Harvard Health Publishing, Harvard Medical School.Do PPIs have long-term side effects?
Ali khan M, Howden CW.The role of proton pump inhibitors in the management of upper gastrointestinal disorders.Gastroenterol Hepatol (N Y); 14(3):169-175.
Masaoka T, Suzuki H, Hibi T.Gastric epithelial cell modality and proton pump inhibitor.J Clin Biochem Nutr. 2008;42(3):191-6. doi:10.3164/jcbn.2008028
Open Anesthesia. The International Anesthesia Research Society.H2-blockers: onset time.
International Foundation for Gastrointestinal Disorders, Inc.Proton pump inhibitors (PPIs), questions and answers about PPIs.
National Health Services.Omeprazole.
U.S. Food & Drug Administration.FDA drug safety communication: possible increased risk of fractures of the hip, wrist, and spine with the use of proton pump inhibitors.
Lazarus B, Chen Y, Wilson FP, et al.Proton pump inhibitor use and the risk of chronic kidney disease.JAMA Intern Med. 2016;176(2):238-46. doi:10.1001/jamainternmed.2015.7193
Lehault WB, Hughes DM.Review of the long-term effects of proton pump inhibitors.Fed Pract; 34(2):19-23.
Yepuri G, Sukhovershin R, Nazari-shafti TZ, Petrascheck M, Ghebre YT, Cooke JP.Proton pump inhibitors accelerate endothelial senescence.Circ Res. 2016;118(12):e36-42. doi:10.1161/CIRCRESAHA.116.308807
Jacob Schoenfeld, J. and Grady, D. “Adverse Effects Associated With Proton Pump Inhibitors.“Journal of the American Medical Association: 176(2):172-174.
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