Proton Pump Inhibitors (PPIs) for GERD

Interior Of A Chemists Shop
Getty Images/Universal Images Group

Proton pump inhibitors (PPIs) are a group of medications that decreases the amount of acid in the stomach and intestines. Doctors prescribe PPIs to treat people with GERD, stomach and peptic ulcers, and other digestive disorders that cause excess stomach acid.

The stomach produces acid to help break down food, making it easier to digest. In certain circumstances, this acid can irritate the lining of your stomach and duodenum (the upper part of your small intestine), causing indigestion and even ulcers.

PPIs work by completely blocking the production of stomach acid. They do this by suppressing a system in the stomach known as the proton pump.

What Is the Proton Pump?

The proton pump is a molecule in certain stomach cells that pumps acid into the stomach. It takes a non-acidic potassium ion out of the stomach and replaces it with an acidic hydrogen ion, which makes things acidic.

By putting more hydrogen ions into them stomach, the pump makes its contents more acidic. But acid secretion into the stomach stops when an individual takes a PPI that stops the proton pump from working.

What Are PPIs Used For?

Proton pump inhibitors are used to treat GERD, stomach and duodenal ulcers, erosive esophagitis and Zollinger-Ellison syndrome. PPIs can be used alone or taken in combination with antacids. PPIS can also be used in combination with certain antibiotics, including Amoxycillin and clarithromycin, in treating the H. pylori bacterial infection.

This type of bacterium is thought to be one of the key causes of recurring stomach ulcers.

All PPIs are similar in how they work, and there is no evidence that suggests one is more effective than another. However, they differ in how they are broken down by the liver and how they interact with other medications.

Additionally, the effects of some PPIs may last longer than others, and may be taken less frequently. PPIs include:

  • AcipHex (rabeprazole)
  • Dexilant (dexlansoprazole)
  • Nexium (esomeprazole)
  • Prevacid (lansoprazole)
  • Prilosec (omeprazole) - also available in over the counter form as Prilosec OTC
  • Protonix (pantoprazole)

PPIs vs. H2 Blockers

PPIs and H2 Blockers both suppress gastric acid secretion; they just do it in different ways. PPIs work by shutting down the proton pumps in the stomach, and H2 blockers work by blocking the histamine receptors in the acid-producing cells of the stomach.

PPIs have a delayed onset of action while H2 blockers begin working within an hour. PPIs work for a longer period of time: most up to 24 hours, and the effects may last up to 3 days. H2 blockers, however, usually only work up to 12 hours.

For more information about specific proton pump inhibitor medications, please use the resources below:

  • AcipHex: prescribed to treat peptic and esophageal ulcers, GERD and erosive esophagitis.
  • Dexilant: prescribed to treat GERD and erosive esophagitis.
  • Nexium: prescribed to treat peptic ulcers, GERD, erosive esophagitis and Zollinger-Ellison Syndrome.
  • Prevacid: prescribed to treat and prevent peptic ulcers, erosive esophagitis GERD and Zollinger-Ellison Syndrome.
  • Prilosec: prescribed to treat peptic ulcers, GERD, and erosive esophagitis.
  • Protonix: prescribed to treat damage from erosive esophagitis and Zollinger-Ellison Syndrome.

See Also


"Pharmacodynamic Aspects of Hz-Blockers versus proton Pump Inhibitors." U.S. Food and Drug Administration. 14 Mar 2007

"Understanding Some of the Medications Often Prescribed for GERD & Ulcers." Common GI Problems: Volume 1. American College of Gastroenterology. 14 Mar 2007

Nicholas J. Talley, M.D., Ph.D., F.A.C.G.,1 Nimish Vakil, M.D., F.A.C.G., "Guidelines for the Management of Dyspepsia." doi: 10.1111/j.1572-0241.2005.00225.x. American College of Gastroenterology. 14 Mar 2007

Frank L. Lanza, M.D., F.A.C.G., "A Guideline for the Treatment and Prevention of NSAID-Induced Ulcers." Vol. 93, No. 11, 1998. American College of Gastroenterology 14 Mar 2007

Colin W. Howden, M.D., F.A.C.G., and Richard H. Hunt, F.R.C.P., F.A.C.G., "Guidelines for the Management of Helicobacter pylori Infection." Vol. 93, No. 12, 1998. American College of Gastroenterology. 14 Mar 2007

Kenneth R. DeVault M.D., F.A.C.G., and Donald O. Castell M.D., M.A.C.G., "Updated Guidelines for the Diagnosis and Treatment of Gastroesophageal Reflux Disease." doi: 10.1111/j.1572-0241.2005.41217.x. American College of Gastroenterology. 14 Mar 2007

Continue Reading