Proton
pump inhibitors (PPIs) are a group of acid reflux
drugs
that
decrease the amount of hydrochloric acid produced
by the cells of the stomach. Doctors prescribe
proton pump inhibitors to treat people with
acid reflux (GERD), ulcers in the stomach or
intestine, or other digestive disorders that may
cause excess stomach acid.
The
stomach produces acid to breakdown food so it is
easier to digest. The acid in the stomach is
produced by the "hydrogen-potassium-AIPase enzyme
system" or "the proton pump". The proton pump is a
molecule in the parietal cells of the stomach that
pumps acid into the stomach. The action of the
pump is to take out a non-acidic potassium ion
from the stomach and replace it with an acidic
hydrogen ion. This hydrogen ion is what makes the
stomach environment acidic. Proton pump inhibitors
stop the action of the pump thereby stopping the
acid secretion into the stomach. Their high
efficiency and long duration of acid inhibition
make PPIs a drug of choice in the treatment of
acid-related diseases.
Clinically,
five groups of proton pump inhibitors are
used:
1)
Omeprazole
(brand names: Losec,
Prilosec)
2)
Lansoprazole
(brand name: Prevacid)
3)
Esomeprazole
(brand name: Nexium)
4)
Pantoprazole
(brand name: Protonix)
5)
Rabeprazole
(brand name: Aciphex)
All
PPIs are similar in their mode of action and there
is no evidence that one is more effective than the
other. However, they differ in how they are broken
down by the liver and how they interact with other
medications. Also, the effects of some PPIs may
last longer than others, and they can be taken
less frequently. Generally, PPIs are well-absorbed
by the body and provide quick relief of heartburn.
Most
people can tolerate PPIs very well, but some may
experience side effects such as constipation,
diarrhea, flatulence, headaches, nausea, abdominal
pain, and vomiting. They are contraindicated in
patients with hepatic disease, during pregnancy,
and breast-feeding mothers. They also interfere
with the action of drugs such as warfarin,
digoxin, methotrexate, antifungals, and oral
contraceptives. PPIs have been shown to increase
the risk of hip fractures in patients above 50
years. The increase in incidence of Clostridium
difficile infections as well as pneumonia is also
associated with PPIs.
While
the efficacy of proton pump inhibitors in
treating acid reflux has been proved beyond
doubt, they cannot be used for more than eight
weeks at a time. Additionally, they merely take
care of the symptoms which reappear once the drug
is withdrawn. The only way to get completely treatd
of acid reflux disease is through holistic
therapy. Acid reflux is a lifestyle disease so
modifications of dietary habits, behavioral
therapy, stress relief, weight management, are all
very essential. Holistic medicine takes care of
all aspects of the body treating it as a whole to
get rid of the disease.
