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is a guide to proton pump inhibitors what theyre for, whether theyre necessary, whether they do any harm, and how to reduce or stop them. WHAT ARE PPIs FOR? Omeprazole and lansoprazole are Proton Pump Inhibitors, often called PPIs. Theyre used for heartburn and indigestion. Theyre also used to protect the gullet and stomach from irritation by aspirin and anti-inflammatory drugs1 ARE PPIs NECESSARY? For a minority of people its important for their safety to take PPIs. Those are people, for instance, who are at risk of internal bleeding from the gut. However, most people like you who take PPIs do so because of heartburn or indigestion: these symptoms are unpleasant but not dangerous. Most people like you can safely reduce or stop your PPIs and many do. ARE PPIs HARMFUL? PPIs have various side-effects most of which seem neither common nor serious. However, its possible that they increase the risk three serious conditions: Clostridium difficile gastro-intestinal infection; fracture; and pneumonia. These harmful effects havent been proved. But if you take any drug for a long time its possible that harmful effects will emerge.2 So its wise to be cautious. Also, if youre overweight or diabetic it might be that indigestion is a useful reminder to eat less your body might be trying to tell you something! HOW CAN YOU REDUCE OR STOP PPIs? Many people stop their PPIs without problems. Some people who stop taking them get a temporary worsening of heartburn or indigestion during the following month.3 This can be treated with an occasional dose of PPI, with a reduced strength of PPI, or with an antacid. Usually the heartburn or indigestion then improves again. After that many people can continue with an occasional dose of PPI, with a lower dose of PPI, with an antacid instead or without any medication. Right now, I suggest you try one of the following two options. Either you take your PPI less often than you have been doing instead of taking it, say, every day, take it every other day. Or ask us to prescribe a lower strength. Please feel free to discuss this with me. Dr Wilf Treasure
1. 2. 3. BNF. British National Formulary (BNF) 64. 64th ed. Joint Formulary Committee, Pharmaceutical Press; 2012. Moayyedi P, Leontiadis GI. The risks of PPI therapy. Nat Rev Gastroenterol Hepatol. 2012 Mar;9(3):132139. Niklasson A, Lindstrm L, Simrn M, Lindberg G, Bjrnsson E. Dyspeptic symptom development after discontinuation of a proton pump inhibitor: a double-blind placebo-controlled trial. Am. J. Gastroenterol. 2010 Jul;105(7):15311537.