Proton pump inhibitors, also called PPIs, is a group of medications that are taken to reduce the body’s acid production. It is done by blocking a specific enzyme found in the wall of the stomach that produces acid. Excess acids can lead to the formation of ulcers in the stomach, duodenum, and esophagus. On the other hand, the reduction of these acids produced by the body can help prevent the development of the aforementioned ulcers. There are a number of different PPIs but evidence suggests that they are very similar in action. Their overall effect shows no difference in terms of effectiveness and efficacy. Proton Pump Inhibitors are usually broken down by the liver in different ways. Some PPIs have longer lasting effects than others making them more ideal in terms of frequency of intake.
What Diseases do Proton Pump Inhibitors Treat?
Proton Pump Inhibitors are primarily used to treat and prevent acid-related health conditions such as esophageal and duodenal ulcers, general types of ulcers, NSAID ( nonsteroidal anti-inflammatory drugs) related ulcers, Gastroesophageal reflux disease (GERD) and Zollinger-Ellison Syndrome. PPIs are also used to complement the effects of antibiotics in combatting Helicobacter pylori (H.Pylori). The said bacterium works together with acids and usually cause stomach and duodenum ulcers. With PPIs, the bacterium Helicobacter pylori and the acid producing enzymes of the stomachs are controlled leading to better management of the symptoms of ulcers.
What are the Common Side Effects of Proton Pump Inhibitors or PPIs
It has been noted that its most common side effects are headaches, diarrhea, constipation, abdominal pain, flatulence, fever, vomiting, nausea, and rashes. However, it has been observed that Proton Pump Inhibitors are mostly well tolerated and easily managed by patients taking them. Its intake may lead to increased colon infection called Clostridium difficile. Increased dosages of PPIs may also result in a higher risk for developing osteoarthritis that can contribute to hip fractures along with fractures of the hip and the spine.
Long terms use of Proton Pump Inhibitors has also been shown to reduce the body’s capability to absorb vitamin B12 or cyanocobalamin. Low levels of magnesium and heart attacks have also been identified as a possible symptom of its long term use. It is therefore recommended that PPIs be used or prescribed for short term use with the lowest level of dosage. There are also some serious side effects of Proton Pump inhibitors which, while considered rare, may have to be considered by patients and medical professionals. These include serious allergic reactions, Steven- Johnson Syndrome, Toxic epidermal necrolysis, decreased kidney function, pancreatitis and Erythema Multiforme.
A recent study also showed that Proton Pump Inhibitors can have a long term effect in the variety of bacteria in the gut. This reduced variation in the types of gut bacteria may expose the patients to greater risk of infections, bone fractures, and various vitamin and nutrient deficiency. Some gut bacteria may be considered bad, but some of the bacteria in the gut are actually just harmless and even beneficial bacteria and helps in digestion and the improved moods. The long term use of PPIs may cause problems in the balance between the good and bad bacteria, eventually giving the bad bacteria the ”upper hand” in the body’s stomach or gut.
What drugs interact with Proton Pump Inhibitors?
Due to the acid-suppressing qualities of Proton Pump Inhibitors, there is a possibility for PPIs to interact with other drugs. Enumerated are the following types of drugs interactions that should be considered for Protein Pump Inhibitors:
- Drug Absorption. The absorption of certain drugs may be affected due to the acid-suppressing characteristics of this certain type of medication. Proton Pumo Inhibitors generally reduce the production of acid in the stomach. This may affect the absorption and concentration of certain drugs such as ketoconazole. Other drugs such as digoxin, on the other hand, may have an increased chance of being absorbed by the body. In short, the efficacy of ketoconazole may be decreased while the efficacy of the digoxin may be increased.
- Drug Processing by the Liver. Proton Pump Inhibitors may affect how the liver processes some drugs. The liver may have a decreased capability of breaking down certain drugs due to the presence of PPIs. This may result in an increased concentration of the said drug in the bloodstream. One PPI that has been observed to increase the concentration of drugs in the body due to reduced liver breakdown is Omeprazole. Omeprazole can increase the concentration of diazepam, warfarin, and phenytoin in the blood.
- Certain Drug Combinations. The Proton Pump Inhibitor Omeprazole has been observed to decrease the overall effect of clopidogrel. This is due to Omeprazole’s tendency to block the conversion of the active form of clopidogrel. In short, the combined intake of Omeprazole and clopidogrel should be avoided.
Moving Forward: What to do after stopping the intake of Proton Pump Inhibitors?
Once it is stopped, patients also need to do their part to remain healthy and to cultivate further their wellness. Stopping the intake of Proton Pump Inhibitors may result in an increase in the body’s acid production. To address this, the patient’s health partner may prescribe slowly weaning off patients from their proton pump inhibitor of choice. Doctors may also recommend several other steps to address Gastroesophageal Reflux Disease (GERD). These include the following:
- Eating smaller portions of meals
- Consuming less fat
- Discourage patients from lying down two (2) hours after eating a meal
- Avoiding snacks before going to bed
- Wearing some loose and comfortable clothing
- Elevating the head a couple of inches higher from the bed and,
- Avoiding foods that may be considered trigger foods such as alcohol, tobacco, and foods that trigger symptoms.