What conditions are proton pump inhibitors used to treat?
Proton pump inhibitors are commonly used:
- To treat ulcers in the stomach and duodenum (part of the gut).
- To reduce acid reflux which may cause heartburn or oesophagitis
(inflammation of the gullet). These conditions are sometimes called
gastro-oesophageal reflux disease or GORD.
- As one part of treatment to get rid of Helicobacter pylori, a bacterium (germ) found in the stomach which can cause ulcers.
- To help prevent and treat ulcers associated with anti-inflammatory drugs called NSAIDs (non-steroidal anti-inflammatory drugs).
- In a rare condition called Zollinger-Ellison syndrome.
- In other conditions where it is helpful to reduce acid in the stomach.
Proton pump inhibitors usually work very well to reduce stomach
acid and to treat the above conditions. They have made a big impact on
the quality of life of many people with these conditions since they
first became available in the 1980s. They are commonly prescribed.
How do proton pump inhibitors work?
Your
stomach normally produces acid to help with the digestion of food and
to kill bacteria. This acid is corrosive so your body produces a
natural mucus barrier which protects the lining of the stomach from
being eroded.
In some people this barrier may have broken down
allowing the acid to damage the stomach, causing an ulcer. In others
there may be a problem with the muscular band at the top of the stomach
(the sphincter) that keeps the stomach tightly closed. This may allow
the acid to escape and irritate the oesophagus (gullet). This is called
‘acid reflux’ which can cause heartburn and/or oesophagitis.
PPIs
stop cells in the lining of the stomach producing too much acid. This
can help prevent ulcers from forming or assist the healing process. By
decreasing the amount of acid they can also help to reduce acid reflux
related symptoms such as heartburn.
They are called ‘proton pump
inhibitors’ because they work by blocking (inhibiting) a chemical
system called the hydrogen-potassium adenosine triphosphatase enzyme
system (otherwise known as the ‘proton pump’). This chemical system is
found in the cells in the stomach lining that make stomach acid.
Can I buy proton pump inhibitors?
Most of
these drugs are prescription only. You can buy omeprazole over the
counter at pharmacies. However, if you need to use this drug for more
than four weeks you should consult your doctor.
How do I take proton pump inhibitors?
Your
doctor will advise you of the dose needed and how often you should take
it. Some of these drugs need to be taken in a certain way, such as on
an empty stomach. Therefore, read the leaflet that comes with your
particular brand for further information.
How quickly do proton pump inhibitors work?
Generally,
proton pump inhibitors are well absorbed by the body and may provide
quick relief for some problems. For example, heartburn caused by acid
reflux. However, if you are taking them for other reasons, such as to
heal an ulcer, it may take longer for the drugs to have an underlying
effect.
How long is treatment needed?
This can vary
depending on the reason you are taking a PPI. So, speak to your doctor
for advice. For example, in some cases your doctor may prescribe a PPI
that you only take 'as required' to relieve your symptoms, rather than
every day. In some cases a regular dose taken each day is advised.
Will my symptoms return after treatment with a proton pump inhibitor?
It is possible that your symptoms might come back if you stop your drug. If this happens, see your doctor again.
Who should not take proton pump inhibitors?
PPIs
may not be suitable for some people. For example, people with certain
liver problems, or pregnant or breastfeeding mums. A full list of
individuals who should not take a PPI is included with the information
leaflet that comes in the drug packet. If you are prescribed or buy a
PPI, read this to be sure you are safe to take it.
What about side-effects?
Most people who
take a PPI do not have any side effects. However, side effects occur in
a small number of users. The most common side effects are:
- Constipation
- Diarrhoea
- Flatulence
- Headaches
- Nausea (feeling sick)
- Abdominal (tummy) pain
- Vomiting
For a full list of possible side effects and cautions, see the leaflet that comes in the packet with your particular brand.
In
particular: tell your doctor if you are taking the blood-thinning drug
warfarin, or a drug for epilepsy called phenytoin (Epanutin) or drugs
called digoxin, methotrexate and cilostazol. Taking a proton pump
inhibitor can affect how well these drugs work, or can even cause
serious 'drug reactions'. Also, lansoprazole possibly affects how well
oral contraceptives might work. Discuss this with your doctor if it is
relevant to you.
If you are taking antacids you should try to
avoid taking them at the same time as you take your other medication,
including PPIs. This is because antacids can affect how well your
medication is absorbed.
Other considerations when taking a proton pump inhibitor
You
should consult your doctor if your symptoms worsen, or if you
experience any of the following problems which can indicate a serious
gut disorder:
- Vomiting blood. This may be obviously fresh
blood, but altered blood in vomit can look like ground coffee. Doctors
call this 'coffee-ground vomit'.
- Blood in your stools (faeces). This may be obvious blood, or it may just make your stools black.
- Unintentional weight loss.
- Difficulty swallowing, including food getting stuck in the gullet.
- Persistent abdominal pain or persistent vomiting.
Disclaimer: This article is for information only and should not
be used for the diagnosis or treatment of medical conditions. EMIS and
PiP have used all reasonable care in compiling the information but make
no warranty as to its accuracy. Consult a doctor or other health care
professional for diagnosis and treatment of medical conditions.
© EMIS and PiP 2008 Reviewed: 30 Jun 2008
