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What about P.P.I. Side Effects?

Posted May 13 2010 4:43pm
A "new" study was recently released and made the CBS NEWS and others. What I've seen so far is not new information. Some is actually "junk science"...i.e., clostridium difficle is an acid resistant spore and hence the pH of the gut should NOT BE RELEVANT since it is not altered by the presence or absence of acid. We can talk about the bias in the retrospective studies because it seems that some of these findings result from the disease state (GERD) not the from the treatment. The only people that take these drugs in these cases are PEOPLE WITH GERD. We have no information on what results would be if non-GERD patients took the same treatment.
That said, ALL meds have some risk. We need to do every thing we can to minimize that risk. The benefit /risk determination needs to be ascertained on a case by case basis. Concern for children should be acknowledged but given the lack of adverse results in the short run (months up to 5 years) I believe the risk (small) is clearly justified given the benefit. Similarily, I would not withhold penicillin in the child with fever and sore throat based on the possibility that anaphylactic reaction could result. The small risk seems acceptable since benefit in both cases is substantial.
I might add that I have treated hundreds of patients with P.P.I.s (Proton Pump Inhihitors) for over 25 years and I remain very impressed with their remarkable benefits and safety.
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