Study notes possible risk of PPI use

ALEXANDRIA, Va. Despite being highly effective and beneficial for many patients, unexpected consequences are emerging in patients who are prescribed proton pump inhibitors for reflux diseases, according to a new commentary published in the November 2009 issue of Otolaryngology – Head and Neck Surgery.

According to the authors, gastroesophageal reflux and laryngopharyngeal reflux 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% 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.

According to the authors, there is a growing body of literature demonstrating that acid is not the only causal agent of tissue damage in reflux disease, and that PPIs, which inhibits acid production in the stomach, are not effective at treating all cases of GERD and LPR.

The authors also suggested that PPIs are associated with rates of hip fractures, possibly related to altered calcium absorption; a 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.