PPI is the acronym for Proton Pump Inhibitors, drugs that reduce stomach acid and are used to treat acid-related disorders of the GI tract. Those disorders are gastric and duodenal ulcers, gastritis, acid reflux, Barrett’s esophagus, and esophagitis among others. Up until now, PPI’s were considered benign and safe to take every day. Like many adults my age, I’ve taken Omeprazole every day for several years. Originally I began taking omeprazole to counteract the irritative effects of NSAID’s my stomach and duodenum. I no longer take an NSAID, but have continued taking omeprazole.
According to GI experts, I may be doing the wrong thing. PPI’s have recently been thought to be harmful and have long-term adverse effects. Public anxiety about this issue has led to nearly 40% of patients discontinuing therapy. When PPI’s were first introduced, physicians were warned to limit use to 14 days. PPI’s are potent acid reducers and cause achlorhydria, which is almost total absence of hydrochloric acid in the stomach. Achlorhydria is the environment in which certain gastric cancers are supposed to develop. Time and the use of PPI’s have proven that concern was over-emphasized, so indiscriminate dosing of PPI’s, even over-the-counter use, has become the norm.
PPI’s have been linked statistically to dementia, fractures, kidney disease, and the previously- mentioned gastric cancer, but none of these disorders have been proven to be caused by PPI’s. They have, however, been shown to increase patients’ susceptibility to acquiring C. difficile, the bacterium that over grows in the intestine after taking broad spectrum antibiotics. C. diff, as it’s called, causes chronic diarrhea, weight loss, and general ill health. Fractures occur due to osteoporosis, but PPI’s have not been shown to have any effect on bone metabolism or cause osteoporosis. That, plus any connection to chronic kidney disease has not been proven.
In the reference for this post, the author states the following: “Portraying these drugs as inherently dangerous risks causes more harm than benefit by fostering fear and undermining trust in life-saving interventions.” The emphasis should shift from fear of harm to being certain PPI’s are being prescribed for appropriate reasons and are clinically justified for an appropriate duration and not taken indiscriminately.
Reference: de la Serna, A. Proton Pump Inhibitors Under Scrutiny: How Real is the Risk? Medscape 2025 December 22.
