Commentary warns of unexpected consequences of proton pump inhibitor use in reflux disease

Nov 03, 2009

Despite being highly effective and beneficial for many patients, unexpected consequences are emerging in patients who are prescribed proton pump inhibitors (PPIs) for reflux diseases. Physicians are warned to monitor these effects and prescribe these medications carefully, according to a new commentary published in the November 2009 issue of Otolaryngology - Head and Neck Surgery.

According to the authors, gastroesophageal reflux(GERD) and laryngopharyngeal reflux (LPR) are diseases that have undergone a remarkable growth in public health relevance over the last 20 years. While it has been known historically that more than 50 percent of adults in Western countries have occasional symptoms of reflux, there has been a more than four-fold increase in how many patients seek medical care for their symptoms.

PPIs are a class of important and generally safe medicines that prevent the release of stomach acid, which is one cause of the burning sensation many reflux patients experience. PPIs are among the most widely prescribed classes of medications for GERD and LPR diseases. But according to the authors, there is a growing body of literature demonstrating that acid is not the only causal agent of in reflux disease, and that PPIs are not effective at treating all cases of GERD and LPR.

In addition to the evidence that acid isn't the only contributing agent in reflux disease, the authors' search of recent research on PPIs pointed out that there are many unexpected consequences and side effects from this class of drugs. They can include: increased rates of hip fractures, possibly related to altered calcium absorption; possible but yet unproven altered vitamin B12 and iron absorption, related to alteration of the gastric pH; increased odds of acquiring nosocomial Clostridium difficile-associated diarrhea; and increased odds of contracting community-acquired pneumonia.

The authors say while it may be premature to make global recommendations about PPI prescribing patterns, they applaud the idea of raising clinical awareness of this medication class and its potential unexpected consequences. In addition, appropriate evaluation and monitoring of patients taking PPIs will be important in determining the need and duration of the use of the medications. The authors further advise physicians treating reflux disease patients to weigh the risks of treatment versus the risks of not treating the disease, and to consider a goal of a more holistic approach that includes diet and lifestyle modification. These additional steps could prove beneficial in lowering healthcare costs associated with reflux diseases, and encourage patients to continue practicing behaviors that would improve their overall health.

Source: American Academy of Otolaryngology -- Head and Neck Surgery

Explore further: Leprosy: Myanmar struggles with ancient scourge

add to favorites email to friend print save as pdf

Related Stories

No link between acid reflux and survival

Jan 04, 2008

Gastroesophageal reflux disease (GERD), often known as acid reflux, is a common problem that has been associated with cancers, asthma, recurrent aspiration and pulmonary fibrosis. A new study published in The American Journal ...

Proton pump inhibitors increase risk of bone fractures

Aug 12, 2008

Patients who use proton pump inhibitors for 7 or more years to treat reflux, peptic ulcers and other conditions are at greater risk of osteoporosis-related fractures, according to this large observational study of 15,792 ...

Recommended for you

Leprosy: Myanmar struggles with ancient scourge

2 hours ago

High in the hills of Myanmar's war-torn borderlands, a clutch of new leprosy cases among communities virtually cut off from medical help is a sign that the country's battle with the ancient disease is far from over.

New analysis questions use of acute hemodialysis treatment

16 hours ago

A common approach to treating kidney failure by removing waste products from the blood did not improve survival chances for people who suddenly developed the condition, in an analysis led by experts at the University of Pittsburgh ...

WHO: West Africa Ebola death toll rises to 1,350 (Update)

16 hours ago

Riot police and soldiers acting on their president's orders used scrap wood and barbed wire to seal off 50,000 people inside their Liberian slum Wednesday, trying to contain the Ebola outbreak that has killed ...

User comments : 0