What are Proton Pump Inhibitors?
Proton Pump Inhibitors
(PPI)are a class of drugs which acts at a cellular level in inhibiting the process of acid secretion. It is the most efficient acid inhibitor available in the market today. It reduces the acid secretion by blocking the enzyme in the stomach wall that produces the acid. Gastric acid is often a cause of major heart burn, intestinal gas and bloating. Reducing gastric acid can prevent ulcers and cause less irritation in existing ulcers.
How do proton pump inhibitors work?
Proton pump inhibitors block the hydrogen/ potassium adenosine triphosphatase enzyme system (the H+/K+ ATPase or the gastric pump) of the parietal cells in the gastrointestinal tract. This particular enzyme action or the proton pump is in the last stage of the gastric acid secretion. It secretes H+ ions directly in the gastrointestinal tract. The PPI s are a class of drugs which target this final stage of the acid production and stop the secretion of the H+ ions. It inhibits gastric acid secretion up to 99%.
Conditions in which PPI is prescribed
- Peptic ulcer disease.
- Gastroesophageal Reflux Disease (GERD).
- Laryngopharyngeal reflux.
- Barret’s Esophagus.
- Dyspepsia (stomach upset or indigestion).
- For treating stress gastritis.
- Gastrinoma( tumor of pancreas or duodenum ) that cause over secretion of gastric acids.
- Zollinger Elisson syndrome (tumor in the duodenum or pancreas producing the hormone gastrin which causes hypersecretion of gastric acids).
Over dosage of PPI s have adverse effects on the body. The Food And Drug Administration advises no more than 14 day treatment courses in a whole year.
The most commonly used PPI is Omeprazole ( marketed under the name Prilosec, Omez, Zegerid, Aciphex). Other PPIs used are Lansoprazole (marketed under the name Prevacid, Zoton, Monolitum, Inhibitol), Esomeprazole (Nexium) etc
Adverse effects of Proton Pump Inhibitors
Short term side effects are as follows:
- Abdominal pain
Long term side effects are as follows:
- Reduced gastric acid can cause malabsorption of nutrients like calcium, magnesium, iron, zinc, Vitamin B12, Vitamin A, selenium etc. The nutrients are absorbed in the stomach wall. This could lead to diseases like rickets,hip fracture, vitamin B12 deficiency etc.
- Pathogenic organisms like bacteria and fungi in the gut are not properly eliminated due to lower levels of gastric acids.
- Prolonged use of PPI causes the over secretion of the hormone gastrin. This hormone signals the brain to increase the production of the gastric acids. Thus a relapse of the condition to begin with is inevitable.