EoE Module 10 References-Vaezi et al Gastroenterology 2017 Complications of Proton Pump Inhibitor Therapy Gastroenterology

Vaezi et al Gastroenterology 2017 Complications of Proton Pump Inhibitor Therapy Gastroenterology

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The article "Complications of Proton Pump Inhibitor Therapy" examines the potential adverse effects associated with long-term Proton Pump Inhibitor (PPI) use. PPIs, used primarily for gastroesophageal reflux disease (GERD) and peptic ulcer disease, have garnered safety concerns due to increased public access and potential overuse. Several studies suggest links between PPI use and conditions such as kidney disease, dementia, fractures, and infections, raising questions about causality versus mere association.<br /><br />The authors review existing literature, applying the Hill criteria — a set of principles to discern causation. Many studies lack strong causal evidence and are subject to biases, such as unmet dose-response relationships, inconsistency, and residual confounding factors. Observational studies, the primary research method in this domain, often fall short of proving causation due to their inherent limitations.<br /><br />Despite the concerns, the article underscores the importance of PPIs for patients when used appropriately at the lowest effective doses. It warns against abrupt PPI discontinuation, which could harm patients with genuine medical needs. Moreover, it advocates for a balanced perspective that considers both risks and benefits.<br /><br />The article suggests that future studies should focus on understanding biological mechanisms rather than only observational reports. Randomized controlled trials (RCTs), though challenging, are recommended to provide clearer causal links. Researchers and media outlets are urged to present data cautiously to prevent unnecessary public anxiety.<br /><br />In conclusion, while some PPI safety concerns exist, they are often not as significant when weighed against their benefits for approved conditions. Proper patient management and cautious prescribing remain crucial, emphasizing PPI use in as-needed scenarios and avoiding over-dosage or inappropriate duration.

Keywords

Proton Pump Inhibitors

PPI therapy

adverse effects

long-term use

causal evidence

observational studies

Hill criteria

patient management

randomized controlled trials

safety concerns