journey18

How do they work?

They work by stopping microscopic acid pumps in your stomach from producing acid. Everyone has a baseline stomach acid production, but this capacity is increased when you eat. i.e. more acid pumps are made to cope with the demand. By taking the tablet 15-30 minutes before you eat, the tablets will be able to knock out the most amount of acid pumps.

This is why we recommend you take these PPI tablets 15-30 minutes before you eat breakfast. Some may be on higher doses requiring taking the tablet twice per day. In this case, take the morning dose as described, and take the evening dose, 15-30 minutes before your evening meal.

There are other tablets that can be used for problematic reflux and if you get persistent symptoms then it would be worth discussing with your GP.

Side effects? Usually very well tolerated, although diarrhoea or other bowel habit disturbance is the most common side effect.

If you are suffering this then it is worth seeing your GP to consider changing to a different PPI.

Are they safe long-term? The short answer to this is probably yes, although a number of issues have been raised.

Clostridium Difficile. If you develop diarrhoea which is not improving after a day or so, after you have been on a PPI for some time, you should see your GP. This is because the use of PPI’s may be linked to a slightly higher risk of developing a certain type of gut infection called clostridium difficile (or “c diff” for short). This increased risk appears to be most apparent if you are of advancing age, have other health conditions, or have had a recent course of antibiotics. Current studies suggest that this risk may be anything from NO risk to approximately double the risk.

Osteoporosis. Some studies have suggested that PPI’s may be a risk factor for developing thin bones (osteoporosis) later on in life. Some studies have however not shown this. Other risk factors for osteoporosis are much more important, such as smoking, being female, family history or an early menopause. PPI’s may contribute to this, but there is NO evidence that people on PPI’s are at such a high risk they need a bone density scan (DEXA) to measure the thickness of their bones.

Salt deficiencies. Again, some studies have shown that patient on PPI’s may have a slightly lower level of certain blood salts (such as magnesium) than others. If you are on tablets such as water tablets (furosemide) then you should have your blood electrolyte levels checked periodically.

Click here or on the picture above, to continue.