Proton Pump Inhibitor Drugs

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Proton Pump Inhibitors – Overview

Proton pump inhibitors are the third highest selling class of drugs in the United States.

NexiumAmongst all the drugs sold in the U.S., Nexium (sometimes called “The Purple Pill”), is the second highest, with retail sales topping $4.8 billion in 2008.

It’s been estimated that the annual advertising and promotional budget assigned to PPIs by the pharmaceutical giants, is greater than the average Third World country’s yearly Gross Domestic Product.

With this colossal expenditure, it’s not surprising that most of the potential PPI side effects are swept under the rug.

Apart from that, the Madison Avenue crowd has succeeded in giving stomach acid a bad reputation.

Finally, two generic brands, Prilosec and Protonix, are now freely available over the counter without a doctor’s prescription… with a third (Prevacid 24HR) soon to follow…

The net result?

People are rabidly abandoning the old acid reflux standby’s in favor of the more effective (and more expensive) proton pump inhibitor. Unfortunately, many of them do so without first consulting their health-care provider.

PS - if you are taking prescription drugs or vitamins of any kind, The People's Chemist is an absolute "Must Read."


How do Proton Pump Inhibitors Work?

Your stomach lining is populated with glands called "Proton pumps" that secrete hydrochloric acid essential for digestion. PPIs block an enzyme required for the production of stomach acid. When this enzyme is blocked, acid production decreases or stops altogether while the drug is active.

This makes regurgitated stomach acid less corrosive, with the following results:

  • Fewer heartburn episodes.
  • Lower heartburn severity.
  • PPIs allow time for the injured esophagus to heal.
However, the over use of PPIs could be counterproductive as explained below.

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Why is Stomach Acid Necessary?

Stomach acid serves a number of essential bodily functions:

  • Without stomach acid, we’d starve to death... The parietal (or oxyntic) cells in the stomach lining, called proton pumps, produce the hydrochloric acid necessary for the early digestion of certain foods.
  • Hydrochloric acid with a pH of 3 or less provides the correct acidic environment for Pepsin to function (pepsin is the enzyme that makes it possible for the stomach to start digesting protein).
  • As with pepsin, a highly acidic environment is necessary for the absorption of vitamin B12. If the stomach acid is diluted in the long term, it could lead to vitamin B12 deficiency.
  • With the exception of the bacterium know as Helicobacter pylori, stomach acid provides a hostile environment for bacteria, viruses and parasites and this strongly acidic environment acts as a built-in barrier to infection.


Are Proton Pump Inhibitors Right for You?

PPIs are very effective and relatively safe in the short term, but not everyone needs them.

If you have been diagnosed with GERD (Gastroesophageal Reflux Disease), short-term use of PPIs is probably best for you.

However, do not to exceed the 8-week dosage period as recommended on the FDA approved package insert; long-term use could result in dangerous side effects.

If you have not been diagnosed with GERD, and yet regularly suffer from acid reflux twice a week or more, the chances are that you do have the disease.

On the other hand, if you only suffer from occasional heartburn episodes, don't waste your money, you’d be better off taking a level teaspoon of bicarbonate of soda dissolved in a little water, or over the counter (OTC) antacids such as Maalox, Mylanta, Rolaids, or Tums.

These antacids usually bring immediate relief. Unfortunately their effect wears off within two or three hours.

OTC H2 blockers, such as Tagamet, Pepcid, Zantac or Axid, take a little longer to stop the pain, however their effect lasts for 12 hours or more and they are fairly safe, provided you don't overdo it.

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