Proton Pump Inhibitors

Proton pump inhibitors (PPIs) belong among the most important discoveries in gastroenterology. They are particularly used in therapy of peptic ulcers and they have significantly reduced the need of surgical treatment.

Principle

The active substances of PPIs inhibit a cell membrane system of stomach cells (parietal cells) that produce the gastric acid. Blockage of the membrane system significantly reduces the acidity in stomach.

Indications

Proton pump inhibitors in all situations when we need reduced production of gastric acid. They are important in therapy of peptic ulcers, gastroesophageal reflux disease and heartburn. Of the rarer indications, PPIs may be used to treat the Zollinger-Ellison syndrome. Proton pump inhibitors are also used in combination with antibiotics when eradicating the Helicobacter pylori.

Used substances

There are many types of proton pump inhibitors; the most commonly prescribed are omeprazole, lanzoprazole, pantoprazole, esomeprazole and rabeprazole.

Disadvantages

The side effects are usually not serious. Decrease of gastric acid activity may somehow disrupt the digestive process and cause loss of appetite and other dyspeptic symptoms. Stomach acid is essential for proper absorption of vitamin B12 and chronic PPI therapy may therefore cause lack of vitamin B12.