Proton pump inhibitors overuse - consequences among patients

Patrycja Kmiotek, Andrzej Materniak, Barbara Skrzydło-Radomańska


Omeprazole was first proton pump inhibitor (PPI) approved for use by patients. Thirty years have passed since then. Due to their effectiveness, low price and safety proton pump inhibitors have become one of the most frequently prescribed medicines in the world. In recent years, more attention has been paid to the problem of their overuse.
Aim of the study
The aim of our study was to investigate the scale of proton pump inhibitors overprescription and possible resulting side effects.
State of knowledge
Analyzed observational studies proves that problem is present both in hospitals and ambulatory clinics. Research shows increasingly frequent use of this medicines in case of non-specific abdominal discomfort or in many cases without any indications. This results in prolonged and unnecessary therapy. The possibility of obtaining medicines over the counter and patients non-compliance, are also a challenge in maintaining high-quality therapy. In many cases patients taking drugs irregularly or do not stop therapy, even being free from symptoms.
Despite the fact that proton pump inhibitors are considered safe drugs, more attention should be paid to the compatibility of their use with recommendations. There are also evidences about the possibility of side effects associated with long-term proton pump inhibitor therapy, which can be particularly dangerous for older patients with multiple diseases. It is necessary to inform patients about the need of discontinuation therapy in case of recovery, which will reduce the risk of adverse effects.


Proton Pump Inhibitors; PPI; Proton pump

Full Text:



Forte JG, Lee HC. Gastric adenosine triphosphatases: a review of their possible role in HCl secretion. Gastroenterology, 1977 Oct;73(4 Pt 2):921-6.

Olbe L, Carlsson E, Lindberg P. A proton-pump inhibitor expedition: the case histories of omeprazole and esomeprazole. Nature Reviews Drug Discovery, February 2003 2, 132–139.

Szymczyk H. Safety of proton pump inhibitor therapy. Lek w Polsce, Vol 25 Nr 9’15 (292).

Strand DS, Kim D, Peura DA. 25 Years of proton pump inhibitors: a comprehensive review. Gut and Liver, Vol. 11, No. 1, January 2017, pp. 27-37.

Shin JM, Sachs G. Pharmacology of proton pump inhibitors. Current Gastroenterology Reports, 2008 December, 10(6): 528–534.

Bashford JN, Norwood J, Chapman SR. Why are patients prescribed proton pump inhibitors? Retrospective analysis of link between morbidity and prescribing in the General Practice Research Database. BMJ, 1998 Aug 15;317(7156):452-6.

Heidelbaugh JJ, Goldberg KL, Inadomi JM. Magnitude and economic effect of overuse of antisecretory therapy in the ambulatory care setting. The American Journal of Managed Care, 2010 Sep;16(9):e228-34.

Ahrens D, Behrens G, Himmel W, Kochen MM, Chenot JF. Appropriateness of proton pump inhibitor recommendations at hospital discharge and continuation in primary care. International Journal of Clinical Practice, 2012 Aug;66(8):767-773.

Eid SM, Boueiz A, Paranji S, Mativo C, Landis R, Abougergi MS. Patterns and predictors of proton pump inhibitor overuse among academic and non-academic hospitalists. Internal Medicine, 2010;49(23):2561-8.

Heidelbaugh JJ, Inadomi JM. Magnitude and economic impact of inappropriate use of stress ulcer prophylaxis in non-ICU hospitalized patients. American Journal of Gastroenterology, 2006 Oct;101(10):2200-5.

Gawron AJ, Rothe J, Fought AJ, Fareeduddin A, Toto E, Boris L, Kahrilas PJ, Pandolfino JE. Many patients continue using proton pump inhibitors after negative results from tests for reflux disease. Clinical Gastroenterology And Hepatology, 2012 Jun;10(6):620-5.

Sheikh I, Waghray A, Waghray N, Dong C, Wolfe MM. Consumer use of over-the-counter proton pump inhibitors in patients with gastroesophageal reflux disease. The American Journal of Gastroenterology, 2014 Jun;109(6):789-94.

Haastrup P, Paulsen MS, Begtrup LM, Hansen JM, Jarbøl DE. Strategies for discontinuation of proton pump inhibitors: a systematic review. Family Practice, 2014 Dec;31(6):625-30.

Seto CT, Jeraldo P, Orenstein R, Chia N, DiBaise JK. Prolonged use of a proton pump inhibitor reduces microbial diversity: implications for Clostridium difficile susceptibility. Microbiome 2014 Nov 25;2:42.

Kwok CS, Arthur AK, Anibueze CI, Singh S, Cavallazzi R, Loke YK. Risk of Clostridium difficile infection with acid suppressing drugs and antibiotics: meta-analysis. The American Journal of Gastroenterology, 2012 Jul;107(7):1011-9.

FDA Drug Safety Communication: Clostridium difficile-associated diarrhea can be associated with stomach acid drugs known as proton pump inhibitors (PPIs). United States, 2012.

Leonard J, Marshall JK, Moayyedi P. Systematic review of the risk of enteric infection in patients taking acid suppression. Am. J. Gastroenterol. 2007 Sep;102(9):2047-56.

Laheij RJ, Sturkenboom MC, Hassing RJ, Dieleman J, Stricker BH, Jansen JB. Risk of community-acquired pneumonia and use of gastric acid suppressive drugs. JAMA 2004 Oct 27;292(16):1955-60.

Toh BH, van Driel IR, Gleeson PA. Pernicious Anemia. N Engl J Med, 1997 Nov 13;337(20):1441-8.

Lam JR, Schneider JL, Zhao W, Corley DA. Proton pump inhibitor and histamine 2 receptor antagonist use and vitamin B12 deficiency. JAMA, 2013 Dec, 11;310(22):2435-42.

Lazarus B, Chen Y, Wilson FP, Sang Y, Chang AR, Coresh J, Grams ME. Proton pump Inhibitor use and the risk of chronic kidney disease. JAMA Intern Med 2016 Feb, 176(2):238-46.

Haenisch B, von Holt K, Wiese B, Prokein J, Lange C, Ernst A, Brettschneider C, König HH, Werle J, Weyerer S, Luppa M, Riedel-Heller SG, Fuchs A, Pentzek M, Weeg D, Bickel H, Broich K, Jessen F, Maier W, Scherer M. Risk of dementia in elderly patients with the use of proton pump inhibitors. Eur Arch Psychiatry Clin Neurosci. 2015 Aug;265(5):419-28.

Jaynes M, Kumar AB. The risks of long-term use of proton pump inhibitors: a critical review. Therapeutic Advances in Drug Safety, 2018 Nov 19;10:2042098618809927.



  • There are currently no refbacks.

Copyright (c) 2019 © The Author(s)

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

Journal of Education, Health and Sport formerly Journal of Health Sciences

Declaration on the original version.

Editors indicates that the main version of the magazine is to issue a "electronic".

The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019.

1223 Journal of Education, Health and Sport eISSN 2391-8306 7

ISSN 2391-8306 formerly ISSN: 1429-9623 / 2300-665X

Archives 2011 - 2014

PBN 2011 - 2014

POL-index 2011 - 2014

BASE 2011 - 2014

Indexed in Bases, Bazy indeksacyjne: ERIH Plus, Worldcat, PBN/POL-Index, ICI Journals Master List, Directory of Open Access Journals (DOAJ), ZBD, Ulrich's periodicals, Google Scholar, Polska Bibliografia Lekarska

US NLM = 101679844

101679844 - NLM Catalog Result - NCBI

Find a library that holds this journal:

Journal Language(s): English 

PBN Poland



Redaction, Publisher and Editorial Office

Instytut Kultury Fizycznej Uniwersytet Kazimierza Wielkiego w Bydgoszczy, Institute of Physical Education Kazimierz Wielki University in Bydgoszcz, Poland 85-091 Bydgoszcz ul. Sportowa 2 Copyright by Instytut Kultury Fizycznej UKW w Bydgoszczy  Open Access ISSN 2391-8306 formerly ISSN: 1429-9623 / 2300-665X

The journal has been approved for inclusion in ERIH PLUS.

The ERIH PLUS listing of the journal is available at

SIC Science citation index (calculated on the basis of TCI and Page Rank) 0

Russian Impact factor 0.16

Indexed in Index Copernicus Journals Master List.,p24782242,3.html

ICV 2018 = 95.95 ICV 2017 = 91.30 ICV 2016 = 84.69 ICV 2015 = 93.34 ICV 2014 = 89.51 Standardized Value: 8.27 ICV 2013: 7.32 ICV 2012: 6.41 ICV 20115.48

The InfoBase Index IBI Factor for the year 2015 is 3.56 in InfoBase


Universal Impact Factor 1.78 for year 2012. (

Indexed in Polish Scholarly Bibliography (PBN) (PBN Polska Bibliografia Naukowa) (

is a portal of the Polish Ministry of Science and Higher Education, collecting information on publications of Polish scientists and on Polish and foreign scholarly journals. Polish Scholarly Bibliograhpy is a part of POL-on - System of Information on Higher Education. It is operated by the Interdisciplinary Centre for Mathematical and Computational Modelling, University of Warsaw.

Indexed in Russian Sciences Index Российский индекс научного цитирования (РИНЦ)

Indexed in Arianta Polish scientific and professional electronic journals Aneta Drabek i Arkadiusz Pulikowski