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Updated: May 18, 2026

The Dyspepsia Educational Tool As a Novel Aid in Dyspepsia Management

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Published on: June 29, 2019

Proton pump inhibitors: potential adverse effects.

Neena S Abraham¹

¹Sections of Gastroenterology and Health Services Research at the Michael E. DeBakey VAMC; Baylor College of Medicine, Houston, Texas 77030, USA. nabraham@bcm.edu

Current Opinion in Gastroenterology

|September 27, 2012

Summary

This summary is machine-generated.

Proton pump inhibitors (PPIs) have limited evidence for many adverse effects, with strongest links to Clostridium difficile infections and bone fractures. Use PPIs cautiously, especially in the elderly and at-risk patients.

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Last Updated: May 18, 2026

The Dyspepsia Educational Tool As a Novel Aid in Dyspepsia Management

The Dyspepsia Educational Tool As a Novel Aid in Dyspepsia Management

Published on: June 29, 2019

Area of Science:

Pharmacology
Gastroenterology
Epidemiology

Background:

Proton pump inhibitors (PPIs) are widely used for acid-related gastrointestinal disorders.
Concerns exist regarding potential adverse effects, necessitating a review of current evidence.

Purpose of the Study:

To summarize adverse effects associated with proton pump inhibitors (PPIs).
To assess the clinical relevance of potential PPI-related adverse events using an epidemiologic framework.

Main Methods:

Systematic review of existing literature on PPI adverse effects.
Application of an epidemiologic framework to evaluate clinical significance.

Main Results:

Limited evidence exists for many PPI adverse events, with strongest support for Clostridium difficile infections and bone fractures in susceptible individuals.
The COGENT trial showed reduced gastrointestinal bleeding risk without increased cardiovascular events when omeprazole was co-prescribed with clopidogrel.
Evidence for pneumonia risk is inconsistent, and while acute interstitial nephritis, nutritional deficiencies, gastric carcinoid tumors, and rebound hyperacidity are biologically plausible, clinical relevance remains largely unproven.

Conclusions:

Prescribe PPIs only for well-established indications.
Exercise caution with PPI use in the elderly and in patients with risk factors for bone fractures or C. difficile infection due to limited strong supporting data for many adverse events.