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George Triadafilopoulos - One of the best experts on this subject based on the ideXlab platform.
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Barrett's esophagus: Proton Pump inhibitors and chemoprevention I: Barrett's esophagus: Proton Pump inhibitors and chemoprevention
Annals of the New York Academy of Sciences, 2011Co-Authors: George Triadafilopoulos, Antonio Taddei, Paolo Bechi, Giancarlo Freschi, Maria Novella Ringressi, Duccio Rossi Degli'innocenti, Francesca Castiglione, Emmanuella Masini, Marek Majewski, Grzegorz WallnerAbstract:The following on Proton Pump inhibitors and chemoprevention in Barrett's esophagus includes commentaries on normalization of esophageal refluxate; the effects of 5-HT(4) agonists on EGF secretion and of lubripristone on chloride channels agents; the role of Campylobacter toxin production; the deleterious effects of unconjugated bile acids; the role of baclofen in nonacid reflux; the threshold for adequate esophageal acid exposure; the effects of Proton Pump inhibitor (PPI) therapy on normalization of esophageal pH and on cell proliferation; the role of the phenotype of cellular proliferation on the effects of PPI therapy; and the value of Symptom Index and Symptom Association Probability in the evaluation of potential response to treatment.
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Adverse effects of long-term Proton Pump inhibitor therapy
Digestive Diseases and Sciences, 2011Co-Authors: Edward Sheen, George TriadafilopoulosAbstract:Proton Pump inhibitors have an excellent safety profile and have become one of the most commonly prescribed class of drugs in primary and specialty care. Long-term, sometimes lifetime, use is becoming increasingly common, often without appropriate indications. This paper is a detailed review of the current evidence on this important topic, focusing on the potential adverse effects of long-term Proton Pump inhibitor use that have generated the greatest concern: B12 deficiency; iron deficiency; hypomagnesemia; increased susceptibility to pneumonia, enteric infections, and fractures; hypergastrinemia and cancer; drug interactions; and birth defects. We explain the pathophysiological mechanisms that may underlie each of these relationships, review the existing evidence, and discuss implications for clinical management. The benefits of Proton Pump inhibitor use outweigh its risks in most patients. Elderly, malnourished, immune-compromised, chronically ill, and osteoporotic patients theoretically could be at increased risk from long-term therapy.
R. C. Mcloughlin - One of the best experts on this subject based on the ideXlab platform.
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The long-term use of Proton-Pump inhibitors
2005Co-Authors: A. S. Raghunath, Colm O'morain, R. C. McloughlinAbstract:More than 15 years after the launch of omeprazole in 1988, Proton-Pump inhibitors remain central to the management of acid-suppression disorders and are unchallenged with regard to their efficacy and popularity among doctors and patients. They are considered safe despite early concerns about the possibility of an association with cancer and gastric atrophy; current concerns about long-term Proton-Pump inhibitor therapy are centred mainly on a possible association with fundic gland polyps and between Helicobacter pylori and gastric atrophic changes, Long-term Proton-Pump inhibitor usage accounts for the majority of the total Proton-Pump inhibitor usage. Long-term usage is difficult to define and most patients take Proton-Pump inhibitors non-continuously. Data indicate that a substantial proportion of long-term users do not have a clear indication for their therapy and there is thus room for reduction or rationalization of treatment. Overall, on-demand therapy is more cost-effective than continuous therapy and should be considered wherever possible.
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Review article: the long-term use of Proton-Pump inhibitors.
Alimentary pharmacology & therapeutics, 2005Co-Authors: A. S. Raghunath, Colm O'morain, R. C. McloughlinAbstract:More than 15 years after the launch of omeprazole in 1988, Proton-Pump inhibitors remain central to the management of acid-suppression disorders and are unchallenged with regard to their efficacy and popularity among doctors and patients. They are considered safe despite early concerns about the possibility of an association with cancer and gastric atrophy; current concerns about long-term Proton-Pump inhibitor therapy are centred mainly on a possible association with fundic gland polyps and between Helicobacter pylori and gastric atrophic changes. Long-term Proton-Pump inhibitor usage accounts for the majority of the total Proton-Pump inhibitor usage. Long-term usage is difficult to define and most patients take Proton-Pump inhibitors non-continuously. Data indicate that a substantial proportion of long-term users do not have a clear indication for their therapy and there is thus room for reduction or rationalization of treatment. Overall, on-demand therapy is more cost-effective than continuous therapy and should be considered wherever possible.
A. S. Raghunath - One of the best experts on this subject based on the ideXlab platform.
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The long-term use of Proton-Pump inhibitors
2005Co-Authors: A. S. Raghunath, Colm O'morain, R. C. McloughlinAbstract:More than 15 years after the launch of omeprazole in 1988, Proton-Pump inhibitors remain central to the management of acid-suppression disorders and are unchallenged with regard to their efficacy and popularity among doctors and patients. They are considered safe despite early concerns about the possibility of an association with cancer and gastric atrophy; current concerns about long-term Proton-Pump inhibitor therapy are centred mainly on a possible association with fundic gland polyps and between Helicobacter pylori and gastric atrophic changes, Long-term Proton-Pump inhibitor usage accounts for the majority of the total Proton-Pump inhibitor usage. Long-term usage is difficult to define and most patients take Proton-Pump inhibitors non-continuously. Data indicate that a substantial proportion of long-term users do not have a clear indication for their therapy and there is thus room for reduction or rationalization of treatment. Overall, on-demand therapy is more cost-effective than continuous therapy and should be considered wherever possible.
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Review article: the long-term use of Proton-Pump inhibitors.
Alimentary pharmacology & therapeutics, 2005Co-Authors: A. S. Raghunath, Colm O'morain, R. C. McloughlinAbstract:More than 15 years after the launch of omeprazole in 1988, Proton-Pump inhibitors remain central to the management of acid-suppression disorders and are unchallenged with regard to their efficacy and popularity among doctors and patients. They are considered safe despite early concerns about the possibility of an association with cancer and gastric atrophy; current concerns about long-term Proton-Pump inhibitor therapy are centred mainly on a possible association with fundic gland polyps and between Helicobacter pylori and gastric atrophic changes. Long-term Proton-Pump inhibitor usage accounts for the majority of the total Proton-Pump inhibitor usage. Long-term usage is difficult to define and most patients take Proton-Pump inhibitors non-continuously. Data indicate that a substantial proportion of long-term users do not have a clear indication for their therapy and there is thus room for reduction or rationalization of treatment. Overall, on-demand therapy is more cost-effective than continuous therapy and should be considered wherever possible.
J H Kleibeuker - One of the best experts on this subject based on the ideXlab platform.
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increased risk of fundic gland polyps during long term Proton Pump inhibitor therapy
Alimentary Pharmacology & Therapeutics, 2006Co-Authors: Mathilde Jalving, Jan J Koornstra, Jelle Wesseling, H M Boezen, De Steven Jong, J H KleibeukerAbstract:SUMMARYBackgroundIt is controversial whether Proton Pump inhibitor use leads to fundicgland polyp development.AimTo determine whether fundic gland polyp development is due to ProtonPump inhibitor use and to investigate mechanisms involved.MethodsProton Pump inhibitor use and the presence of fundic gland polypswere assessed in consecutive patients undergoing oesophagogastroduo-denoscopy. Biopsies from fundic gland polyps and gastric mucosa weretaken. Dysplasia was graded as negative, low or high grade. Prevalenceof parietal cell hyperplasia and parietal cell protrusions and the propor-tional cystic area were assessed.Results599 patients participated, 322 used Proton Pump inhibitors, 107 hadfundic gland polyps. Long-term Proton Pump inhibitor use was associ-ated with an increased risk of fundic gland polyps (1–4.9 years use: OR2.2, 95% CI: 1.3–3.8; ‡5 years: OR 3.8, 95% CI: 2.2–6.7) while short-term therapy (<1 year) was not (OR 1.0, 95% CI: 0.5–1.8). Low-gradedysplasia was found in one fundic gland polyp. Fundic gland polypsassociated with long-term Proton Pump inhibitor use had a larger pro-portional cystic area and higher frequency of parietal cell hyperplasiaand parietal cell protrusion.ConclusionsLong-term Proton Pump inhibitor use is associated with an up to four-fold increase in the risk of fundic gland polyps. Risk of dysplasia isnegligible. Aetiologically, these polyps seem to arise because of parietalcell hyperplasia and parietal cell protrusions resulting from acid sup-pression.
Murray N Ehrinpreis - One of the best experts on this subject based on the ideXlab platform.
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clostridium difficile associated diarrhea and Proton Pump inhibitor therapy a meta analysis
The American Journal of Gastroenterology, 2012Co-Authors: Sailajah Janarthanan, Ivo Ditah, Douglas G Adler, Murray N EhrinpreisAbstract:Clostridium difficile -Associated Diarrhea and Proton Pump Inhibitor Therapy: A Meta-Analysis
