Micronutrient Consequences of Long Term Proton Pump Inhibitor Therapy
N. Inayet *
St George’s Hospital, London, England
A. Poullis
St George’s Hospital, London, England
J. Hayat
St George’s Hospital, London, England
*Author to whom correspondence should be addressed.
Abstract
Proton pump inhibitors (PPIs) are currently the mainstay of treatment for gastro-oesophageal reflux disease, peptic ulcer disease and dyspepsia. In this area, they have enjoyed remarkable success and there are many patients worldwide who use PPIs on a long-term basis. In recent years concerns regarding adverse effects of PPIs have emerged frequently in the medical literature with several small and large scale studies conducted to look into this. The main areas of interest have been increased risk of neuroendocrine tumours, increased risk of dementia, increased risk of infections (enteric, pneumonia, Clostridium difficle), cardiovascular, renal and lower gastrointestinal side effects and effects on mineral and vitamin metabolism. In this review article, we focus mainly on the metabolic consequences of long term PPI therapy.
Keywords: Iron deficiency, B12 deficiency, calcium malabsorption, hypomagnesaemia, osteoporosis