Biochemical Changes Associated with Chronic Proton Pump Inhibitor Use in Adults

Abstract

The Proton Pump Inhibitors (PPIs) amount to one of the most extensively prescribed drug family worldwide. The PPIs are widely indicated in the management of various acid relation gastrointestinal disorders. Diseases like gastroesophageal reflux disease, dyspepsia, Zollinger-Ellison syndrome and pep-tic ulcer disease readily respond to the PPIs.^1,2 This drug class achieves sustained, profound suppression of gastric acid secretion through irreversible inhibition of the hydrogen-potassium ATPase enzyme on the gastric parietal cell membrane. ^2,3  Before the introduction of PPIs, in the late 1980s, histamine-2 receptor antagonists (H2RAs) were commonly used but H2RAs were ousted by the PPIs because of their short-term safety profile and superior efficacy.⁴ Despite of the short-term safety profile, recent studies have raised severe concerns about the biochemical and metabolic ramifications of prolonged PPI usage, specially in the population who are already at risk such as elderly patients or patients who receive polyphar-macy. ^3,6 The developing unnecessary long-term use of PPIs is bestowed upon the availability of numerous PPI formulations that also includes over the counter options.⁵