Conclusions
The reported associations for harm relative to PPI use have received considerable attention across a broad range of adverse effects. Clearly, the literature does show that some of these are related, albeit quite rare and more typically idiosyncratic (eg, hypomagnesemia and interstitial nephritis). As such, these potential adverse effects should be not dismissed but put in perspective relative to the vast universe of patients receiving this class of therapy. The evolving data on C difficile should be monitored carefully. The clinical risk/benefit of any medical intervention or therapy always should be evaluated for each patient and appropriate use of therapy should be directed accordingly. Because PPIs are overprescribed in many patients, in particular for continued long-term use, the clinical effects always should be reviewed and attempts should be justified to stop any therapy that may not be needed.
Abbreviations used in this paper
BMD, bone mineral density; CAP, community-acquired pneumonia; CI, confidence interval; FDA, Food and Drug Administration; GI, gastrointestinal; H2RA, histamine 2–receptor antagonist; IBS, irritable bowel syndrome; OR, odds ratio; PPI, proton pump inhibitor; SBP, spontaneous bacterial peritonitis; SIBO, small intestinal bacterial overgrowth.
Clin Gastroenterol Hepatol. 2013;11(5):458-464. © 2013 AGA Institute
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