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[Reduction of gastric acid secretion: pathophysiologic and clinically relevant sequelae]
1Abteilung für Gastroenterologie und Stoffwechsel, Philipps-Universität Marburg, Bundesrepublik Deutschland.
Zeitschrift Fur Gastroenterologie
|November 1, 1991
Summary
Proton pump inhibitors (PPIs) show minimal long-term safety concerns regarding gastric acid secretion inhibition. While some cell proliferation occurs, risks like carcinoids or cancer appear negligible, though more data is needed.
Area of Science:
- Gastroenterology
- Pharmacology
- Oncology
Background:
- Proton pump inhibitors (PPIs) are widely used for gastric acid suppression.
- Their long-term safety, particularly concerning gastric changes, remains a subject of discussion.
Purpose of the Study:
- To evaluate the safety aspects of long-term gastric acid inhibition by PPIs.
- To assess the clinical relevance of potential side effects like hypergastrinaemia and gastric carcinoid development.
Main Methods:
- Review of existing data on PPIs and their effects on gastric physiology.
- Analysis of serum gastrin levels and gastric endocrine cell proliferation in patients.
Main Results:
- Hypergastrinaemia is not a significant issue in humans, unlike in animals.
- Proliferation of gastric endocrine cells (ECL-cells) is minimal and clinically unimportant.
- Risks of gastric carcinoids, protein/nutrient malabsorption, bacterial overgrowth, and gastric cancer appear negligible.
Conclusions:
- Long-term PPI therapy does not seem to pose significant clinical risks related to gastric acid inhibition.
- Further data from large patient cohorts on long-term PPI use are required before general recommendation.