Here's Why You Should Like Your Proton Pump Inhibitors

Woman taking a pill, close up
Medioimages/Photodisc/Getty Images

With millions of people on Proton Pump Inhibitors (PPI), they have recently become the perfect target for a lot of bad press and research. In my practice, I get asked all the time about why someone would take one of these medications. The reality is that they work really well on some very common problems.    

Many people suffer from heartburn and acid reflux or Gastroesophageal Reflux Disease (GERD).

Whether it is due to food, pregnancy, anxiety, or obesity, most people suffer from heartburn or reflux at some point in their lives. For those who have continuous symptoms, you may have found welcome relief with one of the medications collectively known as Proton Pump Inhibitors (PPIs). Available both by prescription and over the counter, proton pump inhibitors are currently among the most commonly used medications in the United States. Since they were introduced in 1989, they have skyrocketed in popularity becoming one of the most prescribed medications. PPIs are the third-highest-selling class of drugs in the United States with annual sales in 2012 reported to top $9.5 billion! 

Proton Pump Inhibitors Available in the U.S. Market Currently

Brand Name

Generic Name

Prescription / Over The Counter  (OTC)



Prescription and OTC


Omeprazole / Sodium Bicarbonate

Prescription and OTC



Prescription and OTC



Prescription Only



Prescription Only

Dexilant, Kapidex


Prescription Only



Prescription Only


Esomeprazole and Naproxen

Prescription Only

Proton pump inhibitors are considered the most potent medications available for reducing acid in the esophagus, stomach, and duodenum. PPIs reduce acid production by preventing the pumps from producing stomach acid. This makes PPIs effective for treating multiple conditions caused by the stomach acid.

PPIs Can Prevent and Heal Ulcers

Acid is necessary to form most ulcers and reducing acid with PPIs prevents ulcers, and allows ulcers that exist, to heal. However, because PPIs work by reducing acid production, there may not be immediate relief of your acid-related symptoms. It may take anywhere from a few days to several weeks of consistently taking PPIs in order to experience relief and healing of the digestive tract. PPIs are also used with antibiotics to successfully treat H. Pylori infections which is a main cause of ulcers.Your doctor may recommend taking PPIs if you have to stay on long-term NSAIDs to prevent an ulcer.

PPIs can Heal Heartburn (GERD)

More than 25 million Americans suffer from heartburn or GERD daily. Heartburn is a burning sensation that can be felt behind the breastbone. This happens when acid splashes up into the esophagus, and causes pain and even can damage the lining which is called esophagitis. If you haven’t experienced it, you are lucky! For those of us who do, PPIs are like magic.

They have been shown to heal esophagitis in over 90 percent.

Other indications for PPIs include Barrett’s Esophagus (a complication of GERD, resulting in precancerous changes to esophageal tissue) and Zollinger-Ellison Syndrome (a condition where overproduction of stomach acid occurs).

Like all medications, proton pump inhibitors can cause side effects, the most common being; headache, diarrhea, constipation, abdominal pain, flatulence, and rash. However, overall PPIs are generally well tolerated and it is rare for a person to stop using PPIs due to side effects. In fact, they are considered one of the safest classes of medications prescribed by gastroenterologists. With the number of prescriptions growing annually, along with convenient and affordable over the counter access, PPIs have emerged as one of the top-selling categories of medications today.

While considered safe for short-term use, concerns have been reported linking long-term use of proton pump inhibitors to adverse health consequences. Simply put, prolonged reduction of stomach acid may affect the body’s ability to absorb certain nutrients, and create changes in the intestinal microbiome that impact the immune system’s ability to protect against infections. Some of the studies have looked at the possible link between PPIs and increased risk of C. Difficile as well as pneumonia infections.  PPIs have also been linked to an increased risk of developing other digestive issues such as Small Intestine Bacterial Overgrowth (SIBO) and Celiac disease

In my practice, I am constantly being asked whether my patient should be on a PPI or not. There has been a lot of negative press recently, and I plan on expanding more on that in another post, but for those of us who have ever had an ulcer, or suffer from GERD, these little pills can make all the difference in how you feel. Not to mention, both ulcers and reflux can cause serious damage if left untreated. So if your doctor has a good reason to put you on a PPI, do it and then start discussing if and when you will be able to stop the medicines. 


Physicians Desk Reference, PDR Health,

Johnson D, Oldfield IV E. Reported Side Effects and Complications of Long-term Proton Pump Inhibitor Use. ClinGastroenterolHepatol. 2013; 11 (5): 458:464.

Seto CT, Jeraldo P, Orenstein R, Chia N, DiBaise JK. Prolonged use of a proton pump inhibitor reduces microbial diversity: implications for Clostridium difficile susceptibility. Microbiome.2014; 2:42.

Continue Reading