Proton Pump Inhibitors (PPIs) and GERD
Treating Acid Reflux, Heartburn and Ulcer Treatment
Aug 21, 2008
Proton pump inhibitors (PPIs) bind to enzymes in the stomach membrane that produce hydrochloric acid. PPIs reduce levels of stomach acid, and are commonly used to reduce acid reflux symptoms, heal ulcers, and treat gastroesophageal reflux disease (GERD).
Most proton pump inhibitors are available by prescription. Prilosec OTC (over the counter) is available in a non-prescription form for heart burn that occurs two or more times a week. Prilosec OTC is not intended to be used for more than fourteen days without consulting a doctor.
FDA Approved Proton Pump Inhibitors
- Aciphex (rebeprazole)
- Nexium (esomeprazole)
- Prevacid (lansoprazole)
- Prilosec (omeprazole).
Prescription PPIs are usually taken once a day, especially if the medication is used to treat GERD symptoms. Long term use of proton pump inhibitors is commonplace for GERD treatment. When PPIs are used to treat ulcers they are often combined with antibiotics to kill Heliobacter pylori bacteria, which combine with stomach acid to form ulcers.
In addition to preventing GERD symptoms, proton pump inhibitors help prevent and heal erosive esophagitis (damage to the esophageal lining caused by stomach acid). Chronic GERD often results in erosive esophagitis.
PPIs and Heartburn
Proton pump inhibitors are well known to the public by their brand names (Aciphex, Prevacid, etc) and television adverts. There are concerns that PPIs are being overprescribed for heartburn. Occasional heartburn and acid reflux can often be successfully treated without recourse to powerful PPIs, which are better suited to GERD treatment. Antacids, weight loss, diet and lifestyle changes can successfully treat occasional heartburn. Discuss alternative treatments to PPIs with your doctor.
Proton Pump Inhibitors and Side Effects
Proton pump inhibitors generally have few serious side effects. When side effects do occur they tend to include:
- abdominal pain
- constipation
- diarrhea
- headache
- nausea
- skin rash.
Any medication side effects should be reported to medical staff. People with GERD who cannot tolerate PPIs may respond to histamine blockers (also called H2 blockers). Histamine blockers do not reduce stomach acid as effectively as proton pump inhibitors, but are an alterative for people who cannot take PPIs or who have mild GERD symptoms.
PPIs and Health Concerns
While proton pump inhibitors are generally considered safe for long term acid reflux and GERD treatment, some studies indicate extending use of PPIs could cause health complications. It has been suggested that long term PPI use could increase the risk of pneumonia.
A 2008 study found a link between PPIs and osteoporosis fractures. Use of proton pump inhibitors for five or more years coincides with a heightened risk of wrist and hip fractures. Reduced levels of hydrochloric acid may impair the body’s ability to absorb enough calcium for healthy bones.
Disclaimer: The information contained within this article is for informational purposes only, and is not intended to be a substitute in any way for care and treatment by a qualified health professional.
Resources
Drug Digest. (updates March 2008). Proton Pump Inhibitors.
MedicineNet. (updated June 25 2001). Proton Pump Inhibitors (PPIs).
