Adverse Effects of Proton Pump Inhibitor Drugs: Clues and Conclusions

Denis M. McCarthy

Disclosures

Curr Opin Gastroenterol. 2010;26(6):624-631. 

In This Article

Food Allergies and Eosinophilic Esophagitis

Experiments show that a number of ingested potential food allergens that are normally degraded by acid-peptic digestion, become antigenic when the gastric pH rises to values seen during PPI therapy.[34] Other investigations have shown that PPIs dose dependently increase mucosal permeability to small molecules that could include peptide antigens.[20] Adults treated with PPIs for 3 months develop a rise in plasma IgE levels, new food-specific IgE antibodies and a mucosal immune response to offending allergens. A recent hypothesis generating much interest proposes that PPIs may play a key etiologic role in causing eosinophilic esophagitis, as both PPI use and the incidence of eosinophilic esophagitis have risen over closely similar periods.[34]

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