title: Safety of long-term PPI therapy.
abstract: Proton pump inhibitors have become the mainstay of medical treatment of acid-related disorders. Long-term use is becoming increasingly common, in some cases without a proper indication. A large number of mainly observational studies on a very wide range of possible associations have been published in the past decade and are critically reviewed in this article and the existing evidence is evaluated and translated into possible clinical consequences. Based on the existing evidence the benefits of PPI treatment seem to outweigh potential risks in the large majority of patients especially if PPI use is based on a relevant indication. The concern for complications should primarily be directed at elderly, malnourished with significant co-morbidity. In this population an increased risk for enteric infections, fractures and nutritional deficiencies might have clinical consequences and should lead to a careful evaluation of the indication for PPI treatment.
authors.affiliation: Department of Gastroenterology, Hvidovre University Hospital, Hvidovre, Denmark. mail@christinareimer.dk
authors.forename: Christina
authors.initials: C
authors.lastname: Reimer
mesh_terms: D004347:Drug Interactions; D050723:Fractures, Bone / Q000139:chemically induced; D005764:Gastroesophageal Reflux / Q000188:drug therapy*; D006801:Humans; D008286:Malabsorption Syndromes / Q000139:chemically induced; D054328:Proton Pump Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use*
chemical_list: D054328:Proton Pump Inhibitors
keywords: Bone fractures; Campylobacter jejuni; Clostridium difficile; Congenital abnormalities; Malabsorption; Mortality; Neoplasms; Pneumonia; Proton pump inhibitors; Safety; Salmonella