Overprescribing  of proton pump inhibitors 

The prescription drugs – proton pump inhibitors – stop the backflow of acid from the stomach and are used to treat ulcers and to prevent heartburn and gastric reflux but new research from the US suggests that thjey are being massively over prescribed and that given their side effects,  nearly two thirds of prescriptions are 'inappropriate'.

PPIs increase the risk of pneumonia, osteoporosis, broken bones, kidney problems and infection with C.difficile, the superbug that afflicts thousands of older hospital patients every year.

The research, published in the Archives of Internal Medicine, found that while PPIs were effective in several conditions, they are excessively used to treat indigestion when other prescription medicines costing half as much would work just as well, without such severe side-effects.

There were 36 million prescriptions written for PPIs in the UK last year (a threefold rise since 2000) – accounting for 90% of the medications prescribed for dyspepsia.

The US report looked at a series of studies highlighting the side-effects of PPIs. Including an eight-year study involving 162,000 women aged 50 to 79 showed the drugs raised the risk of fractures, particularly in the spine and wrist. It is thought that when PPIs reduce acid secretion by the stomach, it results in less
calcium being absorbed by the body, leading to weakened bones.

One analysis of 100,000 patients discharged from hospitals over five years found PPIs caused a 74% increase in infection with C.diff; another study looked at 1,200 patients being treated for C.diff and found a 42% increased risk of recurrence if PPIs were being used. Doctors say that when PPIs reduce stomach acid it allows the superbug to survive more easily.

Other research has found that PPIs are linked with higher levels of bacterial pneumonia.

For an editorial in the British Medical Journal click here

Proton Pump Inhibitors and Risk for Recurrent Clostridium difficile Infection Arch Intern Med. 2010;170(9):772-778.

Click here for more miscellaneous research on digestive conditions

First Published in September 2010

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