Do you also often get heartburn or chest pain? Or did the doctor say "gastritis"? A type of medicine that doctors often prescribe in such cases is called `(Proton Pump Inhibitors)`. If we were to be blunt, we would probably also call it "medicine for gastritis." So, today we will talk about `(Proton Pump Inhibitors)` or PPIs for short.
Why do we need these PPIs? What happens to stomach acid?
Simply put, `(Proton Pump Inhibitors)` are a type of medicine that reduces the amount of acid produced in your stomach, that is, the amount of stomach acid . Now you may be thinking, "Oh, what's the point of stomach acid? It's not good." That's not true. Stomach acid is very important for our bodies. It is this acid that helps us digest the food we eat. Not only that, but this stomach acid also helps destroy harmful germs that we unknowingly eat with food.
However, sometimes problems start when the amount of stomach acid increases too much, or when the acid goes to a different place than it should. It's like the saying "If it increases, even nectar will be poisonous." That's when stomach ulcers (`ulcers`), or as we call them, "gastritis ulcers" can develop. Other things like heartburn and a sour taste in the throat can also occur. That's when these drugs called PPIs help us. They are especially used for long-term problems related to stomach acid.
What kind of diseases are these PPIs used for?
Doctors mainly use these types of drugs (Proton Pump Inhibitors) to treat conditions such as damage and inflammation to the parts of our digestive system, namely the intestines and esophagus, caused by stomach acid. Let's see what they are:
- GERD or Chronic Acid Reflux Disease: Do you often get heartburn? Do you have a sour taste in your throat? That's what GERD is. Simply put, it's the acid in your stomach that comes up into your esophagus. This can damage the lining of your esophagus, which is also called erosive esophagitis. PPIs work by reducing the production of stomach acid and giving your esophagus time to heal.
- Peptic and duodenal ulcers: Stomach and duodenal ulcers are ulcers that can be caused by stomach acid, which can damage the protective lining of the stomach. They can also cause ulcers in the first part of the small intestine (called the duodenum). PPIs can help to heal these ulcers. In addition, some painkillers, especially nonsteroidal anti-inflammatory drugs (NSAIDs), are associated with an increased risk of developing ulcers. Studies show that about 30% of people who take NSAIDs regularly develop ulcers. PPIs can help to prevent and heal ulcers.
- H. pylori infection: This is a type of bacteria that can live in our stomach. This bacteria can also cause stomach ulcers. When treating an H. pylori infection, doctors often prescribe PPIs along with antibiotics. PPIs change the pH level of the stomach, making it easier for antibiotics to kill the bacteria.
- Zollinger-Ellison syndrome: This is a rare condition. In this condition, certain types of tumors (`tumors`) develop in the body and cause the body to produce too much of a hormone that causes stomach acid. This results in too much stomach acid. PPIs are also used to treat this condition.
How do these drugs called PPIs work? It's amazing, isn't it?
Imagine that there is a little "machine" in our stomach that makes acid. We call this machine the ``hydrogen-potassium ATPase pump'', or the ``proton pump'' for short. Just like a water pump pulls water up, this proton pump is what performs the chemical process needed to make stomach acid.
So, what these `(Proton Pump Inhibitors)` or PPIs do is temporarily stop the functioning of the proton pump . That is, they "inhibit" it, that is, they interfere with it. Then the production of stomach acid decreases.
But this doesn't completely stop the production of stomach acid, right? You still have enough acid left to digest food. If you take a PPI for about five days in a row, the production of stomach acid will be reduced by about 65%. The remaining 35% of acid is enough to digest food.
What are these PPIs?
Some of these PPIs can be purchased over-the-counter (OTC) at the pharmacy without a prescription, but some of the stronger ones require a prescription from a doctor (Rx only).
PPIs that can be taken with or without a doctor's prescription (OTC and Rx):
- Esomeprazole (Nexium®)
- Lansoprazole (Prevacid®)
- Omeprazole (Prilosec®)
- Omeprazole/sodium bicarbonate (Zegerid®)
PPIs that are available only with a doctor's prescription (Rx only):
- Dexlansoprazole (Dexilant®)
- Pantoprazole (Protonix®)
- Rabeprazole (AcipHex®)
How do I take this medicine? How much should I take?
These medications come in either tablet or capsule form. You take them by mouth. Some types of capsules contain a powder that can be mixed into food, such as applesauce, and then taken. This is a great help for people who have trouble swallowing pills.
Before taking the medicine, you should read the instructions on the package carefully. Only then will you be able to get the exact results. There are some types of PPIs that you should take half an hour, an hour before meals, on an empty stomach. When you take them at that time, the medicine has time to work before the stomach acid starts to form when you eat.
Only your doctor can tell you exactly how much medicine you need (`dose`) and how many times a day you should take it. He or she will prescribe a dose that will control your symptoms with the least chance of side effects. For some people, taking one pill before breakfast is enough. For others, taking it twice a day, before breakfast and before dinner, may be enough. Sometimes, taking it every other day can be enough.
Over time, you may need to reduce the dose of your medication. Your doctor will advise you on this as well.
How long does it take for these PPIs to work?
After taking a PPI medication, it can take anywhere from 24 hours to four days to feel its full effect.
If you suddenly have a heartburn or chest pain and need quick relief, it is better to use an antacid (such as Digene, Acidex) or a histamine blocker (H2 blocker) (such as Pepcid® or Tagamet®) than PPIs. Imagine that you suddenly have a heartburn after eating a spicy food. Then, taking such a medicine will provide relief within a few minutes or a few hours. However, its effect does not last as long as PPIs.
PPIs are best if you have long-term, chronic stomach acid problems.
Are there any side effects when using these PPIs?
Most people don't have any major problems when taking PPIs. However, like any medication, they can cause some side effects. These include:
- Stomach ache
- Constipation
- Diarrhea
- Dizziness
- Dry mouth
- Headaches
- Fever
- Bloating/Gas
- Light-headedness
- Itching and rash
- Vomiting
Although PPIs are generally considered safe, researchers have found that they can pose some risks, especially when used for long periods of time . Let's take a look at what they are:
- Clostridioides difficile (C. diff) infection: PPIs can change the balance between good and bad bacteria in your gut, increasing your risk of developing infections like C. diff.
- Fractures: PPIs can reduce your body's ability to absorb calcium, a mineral that helps keep our bones strong. The U.S. Food and Drug Administration (FDA) warns that PPIs may increase the risk of fractures in the hip, wrist, or spine.
- Kidney disease: These can increase the risk of developing chronic kidney disease (CKD), or make existing conditions worse.
- Nutritional deficiency: PPIs can reduce your small intestine's ability to absorb magnesium or vitamin B12. Magnesium is a mineral that helps our muscles and nerves function properly. Vitamin B12 is important for our nervous system and red blood cells.
The link between PPIs and these risk factors is still being studied. However, doctors generally recommend using the lowest dose and for the shortest possible time until your symptoms improve. This will reduce the risk of these risk factors.
When should I see my doctor?
If a doctor has prescribed PPIs for you, be sure to ask your doctor if you have any questions about taking the medication, when to stop, or how to reduce the dosage.
If you are taking PPIs over the counter from a pharmacy and feel like you need them every day to control your symptoms, you should still see a doctor. He or she can advise you on the exact dose and length of time you should take the medication.
Also, if you experience any of these dangerous side effects, see a doctor immediately:
- Allergic reaction (skin rash, redness, swelling)
- Signs of kidney damage (urinating less than before, swelling in the hands and feet, ankles)
- Symptoms of magnesium deficiency (tremors, irregular heartbeat, muscle twitching)
- Symptoms of vitamin B12 deficiency (pain in the hands and feet, numbness, tingling, dizziness, confusion)
- If the skin becomes red, blisters, or looks like it is peeling
- If you have severe diarrhea
- If you have a fever
So, what's the final take-home message?
Having too much stomach acid, or having it in the wrong place, can be very painful. It can also damage your digestive system. Fortunately, there are many medications that can help if you have these symptoms.
For short-term relief, an antacid or H2 blocker is best. But if you have frequent heartburn or have a stomach ulcer, your doctor may prescribe a type of PPI. These medications have been around for years and are considered a safe and effective treatment. Many people find relief with these medications.
The most important thing is that this medicine should be used only under the advice of a doctor, in the prescribed dosage and for the prescribed period. If you try to use it as you please, problems can arise. Therefore, it is wise to always listen to what the doctor says and take the medicine as directed.
` PPIs, gastritis, stomach inflammation, acid reflux, stomach ulcers, omeprazole, pantoprazole
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