Adverse effects of proton pump inhibitors

Lodato, Francesca; Azzaroli, Francesco; Turco, Laura; Mazzella, Natalia; Buonfiglioli, Federica; Zoli, Marco; Mazzella, Giuseppe

doi:10.1016/j.bpg.2009.11.004

« Previous Next »Best Practice & Research Clinical Gastroenterology
Volume 24, Issue 2 , Pages 193-201, April 2010

Adverse effects of proton pump inhibitors

Francesca Lodato, MD
- Department of Internal Medicine and Gastroenterology, University of Bologna, Bologna, Italy
- Department of Internal Medicine, Ageing and Nephrological Diseases, University of Bologna, Bologna, Italy
- Corresponding author. Dipartimento di Medicina Interna e Gastroenterologia, Policlinico Sant'Orsola-Malpighi, Via Massarenti 9, 40138 Bologna, Italy. Tel./fax: +39 051 6364120.
Francesco Azzaroli, MD
- Department of Internal Medicine and Gastroenterology, University of Bologna, Bologna, Italy
Laura Turco, MD
- Department of Internal Medicine and Gastroenterology, University of Bologna, Bologna, Italy
Natalia Mazzella, MD
- Department of Internal Medicine and Gastroenterology, University of Bologna, Bologna, Italy
Federica Buonfiglioli, MD
- Department of Internal Medicine and Gastroenterology, University of Bologna, Bologna, Italy
Marco Zoli, MD
- Department of Internal Medicine, Ageing and Nephrological Diseases, University of Bologna, Bologna, Italy
Giuseppe Mazzella, MD
- Department of Internal Medicine and Gastroenterology, University of Bologna, Bologna, Italy

Proton pump inhibitors (PPI) are very effective drugs used largely in acid related disorders. During the last years concern have been raised regarding their overutilisation in benign condition, such as gastroesophageal reflux disease. The debate focussed also on the risk of adverse events related to long term use of PPI. Apart of the case of Helicobacter Pylori (H. Pylori) positive patients, in whose long term acid suppression lead to the development of corpus predominant atrophic gastritis, precursor of cancer; the other assumed adverse events, have never been demonstrated in prospective studies. The attention should move towards the appropriate prescription of PPI, rather than the fear adverse effects of PPI. In fact, in clinical practise, PPI are often prescribed in patients without a specific acid related disease and continued long term based on their safety profile. This review focus on the main adverse events related to long term PPI use.

Keywords: Proton pump inhibitors, Helicobacter pylori, Gastric cancer