Application of proton pump inhibitors

Heartburn is an unpleasant symptom that can occur in different forms. Mild forms can usually be treated by changing one’s lifestyle and taking antacids (drugs that bind stomach acid). However, if acid-induced stomach complaints and heartburn occur relatively frequently, you should seek medical clarification of the cause.

You could be suffering from an underlying disease requiring therapy for which antacids were not an effective therapy. Proton pump inhibitors are usually used here. In contrast to antacids, these are not freely available in pharmacies, as they require a medical diagnosis!

Proton pump inhibitors (PPI) inhibit the production of stomach acid. Due to the low acidity of the stomach, heartburn and stomach pain quickly subside because the mucous membranes are less irritated. The healing process of esophagitis or inflammation of the stomach wall healing process is therefore effectively supported by PPI.

Patients in whom reflux has anatomical causes, such as diaphragmatic hernia, have a higher risk of developing esophagitis. Therefore, it makes sense to continue to administer prophylactic proton pump inhibitors (PPI) even after a successfully treated inflammation. In patients with a diaphragmatic hernia, PPI is a therapeutic alternative to surgery. Active ingredients that belong to the non-steroidal anti-inflammatory drugs (NSAIDs), such as acetylsalicylic acid, diclofenac or ibuprofen, can attack the protective layer of the stomach. Patients undergoing long-term therapy with NSAIDs should therefore additionally take a proton pump inhibitor.

How do proton pump inhibitors work?

Proton pump inhibitors (PPI) are mainly available in tablet form, but also as capsules. However, their active ingredients are acid-unstable. The acidic gastric juice would decompose the active ingredient before it reaches its destination.

In order to transport the active ingredient undamaged to its destination, the proton pumps of the stomach wall, a detour is taken.The dosage form is coated with a protective layer so that it passes through the stomach without damage and reaches the small intestine. Only there it can dissolve because of the higher pH value. The active ingredient is released, absorbed into the blood via the mucous membrane of the small intestine and thus transported to the proton pumps.

Contrary to many other medicines one does not have to eliminate proton pump inhibitors when setting off. Like any other medication, however, these should only be discontinued on the advice of a doctor. Under certain circumstances, it can be useful to reduce the dosage only gradually, for example to prevent the recurrence of symptoms.