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Related Concept Videos

Acid Suppressive Drugs for Peptic Ulcer Disease: Proton Pump Inhibitors01:13

Acid Suppressive Drugs for Peptic Ulcer Disease: Proton Pump Inhibitors

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Peptic ulcers, often induced by H. pylori infections or NSAID usage, arise from disruptions in the delicate balance of gastric acid production. Peptic ulcers stem from heightened gastric acid levels due to H. pylori infections or NSAID use. The protective mucus layer diminishes in the presence of these factors, allowing gastric acid to erode the stomach lining and form ulcers.
Gastric acid, a potent cocktail of hydrogen and chloride ions, is produced in specialized parietal cells within the...
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Acid Suppressive Drugs for Peptic Ulcer Disease: Antacids01:31

Acid Suppressive Drugs for Peptic Ulcer Disease: Antacids

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In the complex environment of the gastric lumen, excessive acid secretion can lead to the formation or worsening of ulcers within the delicate mucosal layer. Antacids, such as sodium bicarbonate and calcium carbonate, provide relief by neutralizing this acid, transforming it into harmless salt and water. This neutralization process raises the gastric pH from a highly acidic level of 1 to a more basic 3-4, reducing the acidity within the stomach.
However, this neutralization reaction between...
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Peptic Ulcer Disease I: Introduction01:30

Peptic Ulcer Disease I: Introduction

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Peptic Ulcer Disease (PUD) is characterized by mucosal excavation in the esophagus, stomach, pylorus, or duodenum. It can manifest as acute or chronic based on the extent and duration of mucosal involvement.
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Chronic Kidney Disease III: Interprofessional Care01:28

Chronic Kidney Disease III: Interprofessional Care

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Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
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Peptic Ulcer Disease I: Introduction01:25

Peptic Ulcer Disease I: Introduction

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Peptic ulcer disease (PUD) involves breaks in the gastrointestinal tract's mucosal lining, primarily in the stomach and duodenum, with less frequent occurrences in the lower esophagus or near the pylorus.Ulcers can be acute or chronic. Acute ulcers are short-lived with minimal inflammation and heal quickly after the irritant is removed. Chronic ulcers persist, may recur, and often cause scarring due to ongoing tissue damage. Superficial erosions affect only the mucosal layer and are called...
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Peptic Ulcer Disease III: Clinical Manifestations and Complications01:25

Peptic Ulcer Disease III: Clinical Manifestations and Complications

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Duodenal UlcersDuodenal ulcers are the most common form of peptic ulcer disease, presenting with chronic, intermittent epigastric pain. Pain typically appears 2–3 hours after meals, especially when the stomach is empty, often waking patients at night. It is characteristically relieved by food or antacids (“pain–food–relief”). Some patients remain asymptomatic until complications like bleeding or perforation emerge, particularly with NSAID or anticoagulant...
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Updated: Jul 6, 2026

Analyzing Beneficial Effects of Nutritional Supplements on Intestinal Epithelial Barrier Functions During Experimental Colitis
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Published on: January 5, 2017

Association of Long-Term Proton Pump Inhibitor Use With Nutrient Deficiencies: A Retrospective Cross-Sectional Study.

Sarah Nafea1, Chinenye Iguh2, Fariyah Waseem3

  • 1Medicine, Basildon & Thurrock University Hospital NHS Foundation Trust, Essex, GBR.

Cureus
|May 1, 2026
PubMed
Summary

Long-term use of proton pump inhibitors (PPIs) is linked to significant deficiencies in vitamin B12, magnesium, and calcium, with varying prevalence based on PPI type. Routine monitoring is crucial for patients on extended PPI therapy.

Keywords:
calcium deficiencyhypomagnesemiairon deficiencylong-term therapynutrient deficiencesproton pump inhibitorsvitamin b12 deficiency

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Published on: September 20, 2019

Area of Science:

  • Gastroenterology
  • Clinical Nutrition
  • Pharmacology

Background:

  • Proton pump inhibitors (PPIs) are widely used for acid-related gastrointestinal disorders.
  • Chronic PPI use can impair the absorption of essential micronutrients, including vitamin B12, magnesium, calcium, and iron.
  • This impairment may lead to clinically significant nutrient deficiencies.

Purpose of the Study:

  • To investigate the association between the type and duration of PPI use and the prevalence of specific micronutrient deficiencies.
  • To identify differences in deficiency rates among various PPI medications.

Main Methods:

  • A retrospective observational study utilizing electronic medical records from July to December 2025.
  • Inclusion criteria: adults on continuous PPI therapy for ≥6 months.
  • Nutrient deficiencies defined by institutional laboratory cut-offs: Vitamin B12 <200 pg/mL, Magnesium <1.7 mg/dL, Calcium <8.6 mg/dL, Ferritin <30 ng/mL.
  • Statistical analysis included Fisher-Freeman-Halton exact test, chi-square test, and Kruskal-Wallis test (p<0.05).

Main Results:

  • The study included 255 participants (54.5% female).
  • Prevalence of vitamin B12 deficiency was higher with esomeprazole (59.0%) compared to omeprazole (38.6%) (p=0.018).
  • Magnesium deficiency was most prevalent in esomeprazole users (39.3%) versus omeprazole users (11.9%) (p=0.004).
  • Calcium deficiency rates varied significantly by PPI type (p=0.021), with lansoprazole users showing higher rates (31.0%).
  • No significant differences in iron/ferritin deficiency were observed based on PPI type or duration.

Conclusions:

  • Long-term PPI therapy is associated with a high prevalence of vitamin B12, magnesium, and calcium deficiencies.
  • The risk and prevalence of these deficiencies differ significantly depending on the specific type of PPI used.
  • Routine nutritional monitoring is recommended for patients undergoing long-term PPI treatment to mitigate potential deficiencies.