Use of stomach drugs debated

More than half of the people who take PPIs do not need them probably. Simple heartburn can be treated with antacids or other drugs, plus diet and lifestyle changes. For most people, the use of PPIs is considered safe and effective.

It may take longer for a PPI to ease your symptoms than an H2 receptor blocker, which usually starts reducing stomach acid within one hour. However, symptom relief from PPIs will last longer generally. So PPI medications tend to be most appropriate for those with GERD.

Common H2 blocker side effects include nausea, vomiting or upset stomach. These are also some of the more common proton pump inhibitor side effects. Histamine is one of the earliest stimuli that tell the stomach to produce acid. H2 blockers work within an hour. PPIs might take up to four days to start working.


But that trend may be over as more health professionals are taking steps to stop the overprescribing of PPIs, which has accounted for billions of dollars in drug costs (3). There has also been a lot of press on the possible harms of PPIs. There is evidence that people taking PPIs may be more likely to get GI infections (4) but other possible harms may turn out not to be true (5). Nevertheless these studies highlight that you can never be sure a drug is safe and it is important not to take drugs that you don’t really need.

45. Arora P, Gupta A, Golzy M, Patel N, Carter RL, Jalal K, Lohr JW. Proton pump inhibitors are associated with increased risk of development of chronic kidney disease.

A study found Prilosec (omeprazole) and Aciphex (rabeprazole) performed better than other PPI drugs at controlling GERD. Aciphex and Prilosec worked better than other PPIs in high doses. Another study found older patients with esophagitis responded better to the Prilosec and Aciphex than they did to other PPIs.

The long-term use of proton pump inhibitors (PPIs), a class of drugs used to treat acid reflux commonly, is linked to a more than doubling in the risk of developing stomach cancer, finds research. People have dealt with stomach acid-related woes in a variety of ways, proven and otherwise, for eons, but it wasn’t until the mid-1970s and the introduction of cimetidine (Tagamet) that a treatment targeted the production of stomach acid itself. Cimetidine was a huge commercial success; by some accounts, it was the first blockbuster drug. Other drugs in the same class, known as H2 blockers, followed suit quickly, including famotidine (Pepcid) and ranitidine (Zantac).

For that kind of spot duty, the old standbys of antacid medicine like Tums, Rolaids, and Maalox will most likely work just as well, as will any of the H2 blockers. In fact, it takes several days for PPIs to have their full effect on acid secretion, so an H2 blocker may be more effective for a mild, short-term problem with stomach acid. Yet people often take PPIs under the mistaken assumption that they are the better medication in all circumstances. The known fact that omeprazole is available as a generic has narrowed the cost difference, but you’re still probably going to pay more for a PPI, and most definitely so if you are taking one of the expensive brand-name varieties.

difficile bacteria. The trouble is that PPIs – and omeprazole in particular – inhibit an enzyme called CYP2C19 that’s crucial to one of the metabolic steps that activates clopidogrel and its effects.

What is omeprazole for?

Proton pump inhibitors (PPIs) are a group (class) of medicines that work on the cells that line the stomach, reducing the production of acid. They include esomeprazole, lansoprazole, omeprazole, rabeprazole and pantoprazole, and have various different brand names. Al-Aly’s research team will continue to study adverse health effects related to PPIs, in particular regarding those at the highest risk.

November 2017 – Dr Hayley Willacy has been reading recent reports concerning long-term use of PPI medicines and an increased risk of gastric (stomach) cancer – see Further reading below. Researchers from Hong Kong studied 63,397 people who’d been treated for stomach infection with H. pylori bacteria.

Proton pump inhibitors may interact with certain drugs. One example is clopidogrel, sold in the U.S. under the brand name Plavix. They work by blocking the production of stomach acid, giving damaged esophageal tissue time to heal. When the esophagus properly is functioning, its sphincter muscle prevents the backwash of stomach acid from coming up and causing painful irritation and damage characteristic of GERD and heartburn.

Your doctor may also prescribe histamine2 blockers (H2 blockers) for symptoms of GERD, esophagitis, or peptic ulcers. While both PPIs and H2 blockers suppress the production of acid in your stomach, they work in different ways and over different time periods. For example, H2 blockers work within an hour but last only about 12 hours, whereas PPIs need more time to take effect but last up to 24 hours.

Proton pump inhibitors increase risk for hepatic encephalopathy in patients with cirrhosis in a population study. Rabeprazole is equivalent to omeprazole in the treatment of erosive gastro-oesophageal reflux disease. A randomised, double-blind, comparative study of omeprazole and rabeprazole 20 mg in acute treatment of reflux oesophagitis, followed by a maintenance open-label, low-dose therapy with rabeprazole. A randomized, comparative trial of a potassium-competitive acid blocker (AZD0865) and esomeprazole for the treatment of patients with nonerosive reflux disease. Long-term PPIs are also frequently given for prevention of NSAID- or aspirin-related ulcers.

use of drugs called proton-pump inhibitors which lessen stomach acid

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