Long Term Side Effects of PPI Use Pt. 1

Рет қаралды 2,518

7 ай бұрын

Are you currently taking a PPI and consider stopping it because of the potential long term side effects from using it? Did a doctor prescribe a PPI to you, but are hestiant to start because you heard it has long term side effects? If so, this video is for you!
There are four main concerns of long term use of PPIs. But that would be a lot to discuss- so lets talk in this video on the malabsorption of vitamins and minerals and the potential increased risk of infections.
What are the claims made about the malabsorption of vitamins and minerals when you take PPIs for along time? If stomach acid plays a role in absorbing minerals and vitamins then wouldm't decreasing that acid lead to malabsorption? How does our diet contribute to absorption of vitamins and minerals? What if your vitamin and mineral levels do drop slightly, is that bad? Does lower calcium absorption lead to osteoparosis or bad bone health?
Isn't our stomach supposed to be very acidic? Doesn't this acid prevent against GI infections? Is there an increased risk of infections with long term use of PPIs? And if so, what is the magnitude of the risk? What else does the body use to ward off infections?
When should patients try to get off of PPIs? What infections and conditions increase that risk when combined with long term PPI use?
Why do we make so much stomach acid if it isn't really needed? Does our diet require all the stomach acid we produce?
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DISCLAIMER: While I am a Gastroenterologist, I am not acting as your Gastroenterologist. The information provided on this channel is intended to be general educational content and not directed towards any one individual. If you believe you have a medical condition that deserves attention please seek care from your healthcare provider. If you are experiencing a life threatening emergency, call 911.

Пікірлер: 55

@benjamesv 5 ай бұрын

Thanks doc. The internet made me paranoid about PPI, you've cleared it up for me. thanks

@MarkCooperMD 5 ай бұрын

I’m glad it helped. Thanks for sharing!

@Zilero 7 ай бұрын

As someone who was prescribed this for chest pain, it’s totally eliminated it and improved my life in a big way. Unfortunately, there’s a lot of scary articles if you Google the long term effects, but this timely video really made me feel better about not discontinuing it after just a couple of months. Thanks Mark 🙏🏼

@MarkCooperMD 7 ай бұрын

Thanks for sharing that. I’m glad the medicine and the video provided relief.

@Jahnavasundari108 2 ай бұрын

My surgeon agrees that it’s “bad science” and media hype that scare people into thinking PPIs will be the downfall of western civilization 😅 I need to be on PPIs basically forever bc I needed a surgery to permanently open my LES. (So there’s nothing keeping the acid in my stomach anymore.) I was really freaked out about the side effects, so I appreciate this.

@N1ghtSt0rmm 4 ай бұрын

Please do pt 2!!!

@JIMKATSANIDIS 7 ай бұрын

Great information! The short use of PPI may have minor side effects like headache, dizziness, rash, diarrhea, nausea, flatulence and constipation. Long-term usage may lead to chronic kidney disease, bone fractures, dementia, pneumonia, vitamin B12 deficiency. Thanks for the very useful and helpful video Dr. Mark!❤👍

@openletters8597 7 ай бұрын

Your comment doesn't line up with the spirit of the video... He was speaking more of not to worry. Everything you mentioned in your comment, he said was over-hyped.

@MarkCooperMD 7 ай бұрын

Yes all of these have been noted as associations in observational studies. Often using claims data (which is error prone). The effect size is small and the media has reported on association not causation. Most epidemiologist would look for a larger effect size to be convinced of likely causation. Therefore the likely long term effects of ppi are very small and for any condition that warrants their use the benefit exceeds risk except for special conditions.

@JIMKATSANIDIS 7 ай бұрын

@@openletters8597 Fair comment! "Dr. Mark was speaking more of not to worry" does make sense. While there are benefits to these medications, there also are downsides. Any drug that changes the normal physiological process of the body can have unintended consequences, and PPI are no exception. All depends how bad the ulcer is. In some circumstances, a PPI needs to be continued indefinitely, such as when an ulcer doesn't heal.

@kerikrogel9126 4 ай бұрын

After having a little reflux during pregnancy (I hadn't known that pregnancy reflux can go away on its own after pregnancy) my doctor immediately put me on max dosage PPI's, didn't tell me there would be any consequences, and didn't inform me that she planned to have me take them for the rest of my life. When my blood iron dropped to 2 micrograms, I asked if I could get off the PPI's. She dismissed my concerns, but I can't go to another doctor, there is only one doctor who can prescribe medication for a two hour drive from my home. I've been on PPI's for 27 years now, I'm going to switch to a carnivore diet and hope for the best.

@MarkCooperMD 4 ай бұрын

I could do a whole video on the problems here. As far as carnivore diet I wouldn’t recommend that as plants have iron. We are omnivores and not meant to only eat meat. Iron deficiency deserves a work up.

@kavery4625 2 ай бұрын

Any tips for balancing diarrhea that PPI can cause when on PPI for GERD & having IBS-D?

@ilanaryz 7 ай бұрын

I am so glad I found your channel. My husband was recently diagnosed with EOE, and you provide so much of great information. He is getting ready to start elimination diet and he needs to take PPI at the same time. He doesn't have any symptoms, so it was only endoscopy that confirmed the diagnosis. I do however have a question if I may. How about interaction with thyroid medication like Levoxyl? Both, PPI and Levoxyl need to be taken on an empty stomach, but can't be taken at the same time. And there is also some information that PPI may affect absorption and levels of Levoxyl may need to be adjusted. Would like to hear your thoughts, or maybe even a video about medication interactions. Thank you.

@MarkCooperMD 7 ай бұрын

I believe thyroid meds need a longer period of time to absorb before a meal - around 1-2 hrs. I would just time them accordingly, which is a nuisance. The PPI doesn’t actually work until you eat.

@ilanaryz 7 ай бұрын

Thank you.

@ImNotSneeky 6 ай бұрын

Hello! I have EOE and Gluten was the main cause after doing the elimination diet. I have EOE and Barretts esophagus. I had really bad EOE symptoms and every time I had gluten it felt like i was chocking. My dr. put me on PPI, but after my own research I decided, I didn't want to take them and wanted to work more on my diet and maintaining a healthier lifestyle.

@MarkCooperMD 6 ай бұрын

Thanks for watching. It’s great when a person can follow an elimination diet and control their eoe. Check out the video on eoe diets. Hope it continues to go well.

@likethepear 3 ай бұрын

I’m terrified. I have crohns and am on Remicade so I’m kind of used to gastric issues but lately acid reflux has been really getting to me. Last night after sleeping for an hour I woke up choking on vomit.Even when I stop eating 6 hours before bed and don’t eat anything spicy or fatty this still happens. The acid/vomit was on my sheets and I was gasping for air. This has happened a few times. I’m terrified I’ll end up with pneumonia from it. my gastroenterologist put me on Aciphex last year for 4 months and it worked great. I could eat anything anywhere anytime but I had to. Stop taking it after four months. I don’t understand why they make these great drugs that you can only take for a short period. It was like I had a normal life and now I don’t know what to do. I’m so depressed, afraid to go to bed. I can’t sleep on a wedge because of neck problems. I don’t know what to do anymore except just stop eating all food .

@supersonicsenses 2 ай бұрын

Look up the huge amount of people who are putting crohn's and ulcerative colitis into remission with plant free (eg carnivore) diets.

@KittyKat-jv8nq 5 ай бұрын

I keep reading from many sources that taking a hydrochloride acid supplement will help with digestion. Is there any situation where this will help? Im a long time ppi user but have bloating and gas.

@MarkCooperMD 5 ай бұрын

Ingesting hydrochloric acid is danger akin to injecting bleach for Covid. Both are bad ideas.

@KirstinRN 5 ай бұрын

Have you heard of gastric polyps related to long term ppi use? I recently had an endoscopy & colonoscopy due to abdominal bloating, nausea, change in bowel habits (w/ history of colon polyps) & because of my history of GERD. They found that I have several gastric polyps (over 30, some very large at 2cm) & want me to stop taking a ppi. I had no idea that was a long term complication/risk factor. However, I was told they should shrink & go away when I stop the ppi. Have you seen that in practice before? I’ve been on a ppi for many years.

@MarkCooperMD 5 ай бұрын

Numerous times - it’s common and actually harmless, not a reason I’d tell people to stop a PPI. Though it’s worth seeing how you do without it for the simpler reason of minimizing medications where possible.

@blueberry4082 7 ай бұрын

Is there any exercises that you recommend for acid reflux? I feel bitterness in my mouth and throat every single day for a long time. Can’t wedge my bed because of neck pain. Keep drinking baking soda and water!!! And keep burping. I’m very worried about my esophagus 😢😢

@RandomPerson-yc4vm 6 ай бұрын

Same man I know how you fell

@janetrodriguez5445 3 ай бұрын

Please do part 2. My medication for cronic pain causes LPR which is acid reflux in the throat and air ways that responds to 40mg of omeprozole. When I am off the medication LPR goes away and no need for PPI. However I am in so much pain can’t do anything and no other medication has been able to help my cronic pain. I want to go back to my original medication because it works even though it causes LPR and I will need to be on a PPI long term. But everything online about PPI scares me. Please advise Dr.

@chadgross8758 5 ай бұрын

Hello Dr. Cooper, Thank you for the excellent video. I have a question for you. I have been reading that acid reflux and heartburn are most often the result of low stomach acid, not too much stomach acid. So, if this is true, isn't treating AR and heartburn with PPIs counterproductive? Please know that my question is sincere and I am not trying to contradict anything you have said here. I am seeking understanding. Thank you again for helpful video. It was a nice change of pace from the typical "PPIs are the devil" videos!

@MarkCooperMD 5 ай бұрын

Please check out the other videos on GERD for more explanation. In short it’s not accurate and a concept created by TikTok. The problem is there’s too much reflux and it’s not a problem of acid in either direction.

@nwz6084 21 күн бұрын

I have taken PPI for 12 days. I have felt tired, brain fog, joint pain. I decided not to take them. my symptom is only reflux, and this is not worth it. But I need to know. Is the PPI inhibiting cognition permanent damage? I'm scared. and alone. please let me know.

@BA-be5vm 3 ай бұрын

Great video. Lansoprazole is the only thing that seems to help my acid reflux from a hiatal hernia, i am only young and have already been on the PPI for years, i am worried that i will be on them forever and it will have negative consequences on my health.

@RealTraderScalper 6 ай бұрын

Is it true that long term ppi use are directly linked to cause IBD

@MarkCooperMD 6 ай бұрын

No - that’s not true. IBD existed long before PPIs.

@Outlander18 7 ай бұрын

What do you suggest for hiatal hernia reflux?

@MarkCooperMD 7 ай бұрын

Thanks for watching. Please check out the other videos that cover hiatal hernia.

@mari051986 24 күн бұрын

Can we just take B12, magnisium, Vitamin D and calcium along with PPIs to avoid these risks? or is not working like that?

@MarkCooperMD 23 күн бұрын

Vitamin D is fat soluble so acidity shouldn’t matter at all for its absorption. The others are theoretical risks but little evidence that most people should need vitamins. A good diet should have more than enough nutrients. Most of your GI tract is neutral anyhow so acidity is not essential for a lot of absorption. B12 and magnesium are easy enough to supplement however if you take a PPI for a very long time.

@mari051986 23 күн бұрын

@@MarkCooperMD tbh you are one of the few in here saying that PPIs long term for men and women are not that bad...with very low chances to face any issue on the long term! Many thanks for that, really appreciate it. I live in EU and my gastroenterologist suggested to take them long term with good diet because when i was born i had Esophageal atresia and some other issues that were fixed finger crossed. Now at the age of 40 i found out i have relatively small hiatal hernia at 1.8cm, lose sphincter, gastritis and GERD. I take seriously my health so i'm very careful of what i'm eating from the day i found out (9 months ago) but inflammation is still there. I take PPIs 4 times a week twice 40mg and twice 20mg pariet. I had two endoscopies within 9 months both times i have inflammation but i think is reduced now due to my diet and PPIs. Only symptom is LPR but once in a month i might get the pain under my chest. However, inflammation is still there.. In general i was worried about the long term side effects of PPIs so thank you for your explanation and giving me hopes that i can use them for the next 20-30 years

@TaembedzwaMajaya 4 күн бұрын

I have terrible GERD and I have been on Dexilant for close to 2yrs now. But i also have chronic urticaria and connective tissue disorder. I am on high dose of Xolair and I also take hydroxychloroquine. But lately my GERD has been extremely painful and don't know how to manage it and i am a young mum seeking for a better quality of life

@MarkCooperMD 3 күн бұрын

What you describe raises suspicion for eosinophilic esophagitis. You may benefit from a scope with esophageal biopsies if not previously done. Please discuss this with a GI doctor.

@TaembedzwaMajaya 3 күн бұрын

@@MarkCooperMD thank you. I will look into this.

@dearsubrata1213 3 ай бұрын

In KZfaq one Gastroenterologist said that more than 3 months use of PPI can cause H pylori infection and risk of cancer. I have gastritis and i have taken PPI that was given by my Dr total around 5 months. Then have i chance of cancer or H pylori infection? Pls I'm very very afraid about this ...help me doctor 🙏🙏

@MarkCooperMD 3 ай бұрын

If that was accurate there should be millions more cases of stomach cancer. PPIs do not cause these problems.

@dearsubrata1213 3 ай бұрын

@@MarkCooperMD Thank you Doctor.... KZfaq is full of biased informations, mostly said on one's own opinion.

@MarkCooperMD 3 ай бұрын

Thanks. I review papers on pubmed before making a video. I try to distill down that science into an easy to access format. New information comes up of course but my aim is to be accurate.

@dearsubrata1213 3 ай бұрын

@@MarkCooperMD Thanks doctor....We always see doctors like you as messengers of God

@garrettvalentine6051 2 ай бұрын

I got sibo

@sherrygamble6950 7 ай бұрын

What is a PPI?

@Thefesty87 7 ай бұрын

Proton Pump Inhibitor. Stops the stomach from producing acid.

@JIMKATSANIDIS 7 ай бұрын

Sherry, PPI is: Proton pump inhibitors. They are medicines that work by reducing the amount of stomach acid made by glands in the lining of your stomach. They relieve symptoms of acid reflux, or gastroesophageal reflux disease (GERD).👋

@MarkCooperMD 7 ай бұрын

Thanks that covers it. Sorry I didn’t specify more in this video. There are several other videos on their correct use, other means to combat gerd and upper GI symptoms, and stop them successfully.