Why think twice before prescribing proton pump inhibitors

Area of Science:

• Gastroenterology
• Pharmacology

Background:

• Proton pump inhibitors (PPIs) are frequently prescribed for acid-related disorders due to their efficacy.
• Their mechanism of action and metabolism lead to a wide range of reported adverse effects.
• Despite their success, insufficient attention is given to the multiple adverse effects associated with PPIs.

Purpose of the Study:

• To review the most common adverse effects of proton pump inhibitors (PPIs) specifically on the gastric mucosa.
• To highlight the impact of PPIs on gastric pH and the gastric mucosal environment.

Main Methods:

• This is a review article, synthesizing existing literature on PPIs and their adverse effects.
• Focus is placed on studies examining the impact of PPIs on the gastric mucosa.

Main Results:

• PPIs directly alter gastric pH, influencing the gastric mucosa.
• Adverse effects on the gastric mucosa are common and varied.
• PPIs alter the composition of gut and gastric microbiota.

Conclusions:

• Proton pump inhibitors (PPIs) significantly affect gastric and gut microbiota composition.
• These alterations in microbiota can modulate the host's immune response.
• Further well-designed prospective trials are needed to accurately assess PPI adverse effects.