Taking Proton Pump Inhibitors (PPIs)? Here's What You Should Know

If you or someone you care about are taking Proton Pump Inhibitors (PPIs) for heartburn, acid reflux, or other gastrointestinal symptoms, it might be time to take a closer look at the pills you're taking.

What Are PPIs?

Proton pump inhibitors or PPIs are a class of medications designed to reduce the amount of acid in the stomach. They’re commonly prescribed for:

• Gastroesophageal reflux disease (GERD)

• Ulcers of the stomach or small intestine

• Inflammation of the esophagus

• Frequent heartburn

  
  

Some of the most commonly used PPIs include:

• Omeprazole (Prilosec)

• Esomeprazole (Nexium)

• Lansoprazole (Prevacid)

• Rabeprazole (AcipHex)

• Pantoprazole (Protonix)

How Long Should PPIs Be Used?

According to FDA-approved guidelines, many PPIs are recommended for short-term use, often up to 8 weeks, and not studied extensively beyond 12 months. Yet, many people continue taking them for years without revisiting the risks involved.

Here are some examples of FDA approved indications taken from a package insert for a well known PPI.

FDA Drug Safety Communications

The FDA is revising the prescription and over-the-counter (OTC) labels for PPIs to include new safety information about a possible increased risk of adverse effects.

Adverse effects have been associated with nutrient deficiencies, digestive disorders and other conditions including:

(Please click links for the FDA Drug Safety Communications on PPIs)

• Clostridium difficile associated diarrhea

• Fractures (hip, wrist, spine)

• Low calcium (hypocalcemia)

• Low magnesium (hypomagnesemia)

• Low potassium (hypokalemia)

• Low sodium (hyponatremia)

• Erectile dysfunction

• Severe cutaneous adverse reactions

Research on the Risks of PPIs

Emerging studies continue to highlight risks linked to prolonged PPI use:

Infections

• Pneumonia  

• Small Intestinal  Bacterial Overgrowth (SIBO)

• Clostridium difficile (C. diff) and Colitis

Metabolic & Nutrient Imbalances

Long term use of PPIs can cause:

• Elevated liver enzymes and triglycerides

• Increased CK (creatine kinase)

• Magnesium depletion

• B12 deficiency

These imbalances increase risk of fractures, skeletal muscle loss, cognitive decline and anemia.

Cognitive Decline & Dementia

Research links prolonged use of PPIs to poorer cognitive performance. One study showed a 51% increase risk of developing dementia in PPI users.

Cancer

PPI use is associated with increased risk of cancer:

• Bile Duct (cholangiocarcinoma)

• Gastric Cancer

• Kidney (renal cell carcinoma )

• Liver (hepatocellular carcinoma )

• Lung Cancer

• Pancreatic

So, if you’re currently taking a PPI, or considering it, now might be the perfect time to explore what’s really going on beneath the surface. It's important to focus on identifying root causes like:

• Nutrient deficiencies

• Gut microbiome imbalances

• Underlying digestive disorders

Additional Resources:

1. https://www.fda.gov/search?s=proton+pump+inhibitors

2. https://pubmed.ncbi.nlm.nih.gov/40189643/

3. https://www.fda.gov/search?s=proton+pump+inhibitors

4. https://pubmed.ncbi.nlm.nih.gov/39856755/

5. https://pubmed.ncbi.nlm.nih.gov/40189290/

6. https://pubmed.ncbi.nlm.nih.gov/39442126/

7. https://pubmed.ncbi.nlm.nih.gov/40183554/

8. https://pubmed.ncbi.nlm.nih.gov/39932099/

9. https://pubmed.ncbi.nlm.nih.gov/39681582/

10. https://pubmed.ncbi.nlm.nih.gov/31296980/

11. https://pubmed.ncbi.nlm.nih.gov/30018559/

12. https://pubmed.ncbi.nlm.nih.gov/39749203/

13. https://pubmed.ncbi.nlm.nih.gov/39749203/

14. https://pubmed.ncbi.nlm.nih.gov/29105111/

15. https://pubmed.ncbi.nlm.nih.gov/40075724/

16. https://pubmed.ncbi.nlm.nih.gov/30288155/

17. https://pubmed.ncbi.nlm.nih.gov/28676480/

18. https://pubmed.ncbi.nlm.nih.gov/31147311/