Proton Pump Inhibitors

While stomach acid is a normal occurrence and is actually needed for digestion, it can be dangerous when there’s too much of it. It can cause irritation and inflammation of the esophagus, which can lead to heartburn or even ulcers. PPIs or proton pump inhibitors are used by those suffering from ulcers and acid reflux to bring the amount of acid produced in the stomach under control. For the most part, those who take PPI do not develop any adverse reactions.

What Are Proton Pump Inhibitors?

As mentioned earlier, PPIs are a type of medication that helps to reduce the amount of acid produced in the stomach and intestines.

They are used to treat the following conditions:

  • Ulcers in the duodenum and the stomach
  • Acid reflux that can lead to inflammation of the gullet (esophagitis) or heartburn. The two conditions are also referred to as GERD (gastro-esophageal reflux disease)
  • Helicobacter pylori, which is a bacterium that causes ulcers. PPIs are used as part of the treatment
  • Prevention and treatment of ulcers caused by non-steroidal anti-inflammatory drugs (NSAIDs)
  • Treatment of the Zollinger-Ellison syndrome
  • Reduction of acidity in the stomach when necessary

Different Types of Proton Pump Inhibitors

There are several types of Proton Pump Inhibitors. They include:

  • Omeprazole (Prilosec) – available over the counter without a prescription.
  • Lansoprazole (Prevacid)
  • Esomeprazole (Nexium)
  • Rabeprazole (AcipHex)
  • Dexlansoprazole (Kapidex)
  • Pantoprazole (Protonix)

Differences Among Proton Pump Inhibitors

Generally, PPIs work in the same way. There is little evidence to show that any of them works better than the rest. They only differ in the manner in which they are broken down by the liver and their interaction with medication. Effects of taking some PPIs which last longer than others and should, therefore, be taken less frequently.

How Do Proton Pump Inhibitors Work?

Production of acid in the stomach is normal. The acid is important for digestion and killing of bacteria. Due to the fact that the acid is corrosive, the stomach walls are protected from erosion by a natural mucous barrier.

This layer of mucous can sometimes get broken down, exposing the stomach walls to be damaged. In some cases, the acid can find its way into the esophagus (gullet) if the sphincter muscles that keep the stomach shut have a problem. This is what is commonly referred to as acid reflux and causes heartburn or/and esophagitis.

Proton pump inhibitors help control the production of acid in the stomach. This effectively prevents the development of ulcers and facilitates the healing process. The symptoms of acid reflux are also reduced as a result of the reduction in the amount of acid in the stomach.

The name “proton pump inhibitor” refers to the fact that they inhibit or stop a chemical system called hydrogen-potassium adenosine triphosphatase enzyme system (also called ‘proton pump’). This chemical system is responsible for the production of acid in the stomach.

The video below will show you the mechanism of proton pump inhibitors in animation:

How to Take Proton Pump Inhibitors

PPIs are meant to be taken orally. They come in capsule or tablet form. Typically, they should be taken about half an hour before the day’s first meal. You can easily get some PPI brands over the counter without the need for a prescription. If you find that you are taking this medication too frequently, then it is time to see your doctor.

Frequency varies on a case by case basis. Some people suffering from acid flux need to take PPIs on a daily basis. In some cases, one can take them every other day. If you are suffering from a peptic ulcer, you might be required to take PPIs along with other medicines for about two weeks. In other cases, you might have to take them for eight weeks.

If you get a prescription for these medicines you need to:

  • Follow the prescription to the letter
  • Don’t stop without permission from your doctor
  • Take them medicines at the same time every day
  • Plan ahead so that you do not run out of medication. This is especially so when you are travelling

Considerations Before Taking Proton Pump Inhibitors

People Who Shouldn't Take Proton Pump Inhibitors

There are people who shouldn’t take PPI under any circumstances. This includes people who are pregnant (they can, however, take omeprazole) or breastfeeding. If you want a full list of those that shouldn’t, you can always check the information leaflet included in the medicine packet.

Drugs to Avoid When Taking Proton Pump Inhibitors

Before you can take PPIs, you should let your doctor know if you are taking any of these drugs:

  • Antibiotics
  • Asthma medications
  • Sedatives
  • Tranquilizers
  • Seizure medications
  • Ulcer medications
  • Anticoagulants

What Are the Side Effects of Proton Pump Inhibitors?

PPIs are generally safe and interchangeable as they work in the same way. Also, they rarely cause any side effects. Nevertheless, it is worth noting that they can cause certain infections since they reduce acidity in the stomach. They can also interfere with the absorption of certain medicines.

Here is a list of some of the side effects of PPIs:

  • Constipation
  • Vomiting
  • Flatulence
  • Diarrhea
  • Headaches
  • Abdominal (tummy) pain
  • Nausea (feeling sick)

Though rare, there are also some severe side effects that you should watch out for. They include:

  • Peeling and swelling of the skin accompanied by a skin rash
  • Hives
  • Swelling of feet, hands, or ankles
  • Swelling of the mouth, face, tongue, or lips
  • Difficulty in swallowing or breathing
  • Severe diarrhea
  • Hoarseness

Make sure to seek the advice of a doctor in case you develop the above side effects. The leaflet found in the packet also contains a comprehensive list of side effects and cautions.

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