Side effects are generally rare when taking proton pump inhibitors (PPI). If symptoms do occur, there is usually a harmless undesirable effect behind it. Overall, side effects occur in 3-10% of patients.
Side effects with short-term use
It is optimal if the drug is only used for a short time. Then you can expect at most fatigue, headaches, sleeping problems, dizziness, nausea, as well as skin rash or itching. From time to time diarrhea, intestinal wind, constipation or upper abdominal discomfort may also occur.
Side effects with long-term use
The side effects of short-term use usually disappear again with longer use. However, other problems may occur, which are currently being investigated in more detail. Critics have suggested that proton pump inhibitors are prescribed too much and too carelessly – the pharmaceutical industry generates global sales of USD 26.5 billion (2008) every year with these drugs alone.
Moreover, the pharmaceutical industry would sell the drugs as “stomach protection”, which was euphemistic. In any case, one must be aware that one is still taking a drug that, by blocking the proton pumps, makes the environment of the stomach less acidic. Studies have shown that >90% of acid production is inhibited when taken continuously.
Of course, this can be useful in case of a corresponding disease. But such inhibition also carries risks. So every physician should carefully check the indication to see whether a prescription of a proton pump inhibitor is justified and also carefully adjust the dosage. Possible adverse effects can manifest themselves, for example, in a disruption of bone metabolism, an increased risk of intestinal infection or lung infection.
Bone metabolism
A proton pump inhibitor inhibits the absorption of calcium in the stomach by making the stomach environment less acidic. As a result, less calcium is broken down from food and absorbed through the mucous membranes. A calcium deficiency can lead to bone fracture. In animal experiments, an effect on bone metabolism was also directly demonstrated in the bones, which led to increased bone resorption in laboratory animals. For this reason, proton pump inhibitors should be taken with caution, particularly in older people, women with osteoporosis or people with numerous other diseases (comorbidities), and the doctor should be consulted regularly in the case of high-dose therapy.
