Proton pump inhibitors or PPIs are an acid reflux medication that helps relieve and prevent bouts of reflux symptoms by reducing the production of acid in the stomach. Digestive juices may still backwash into the esophagus, but they are not as acidic as they once were. Therefore, irritation is decreased.
The goal of proton pump inhibitors is to reduce the severity and frequency of acid reflux disease. However, the medication does not address the cause of acid reflux. Acid production is reduced for the duration that the medication is used. Once medication use ceases, acid levels will return to normal. Without correcting the cause of acid reflux, symptoms will typically return.
Common PPIs available in the United States include:
- Prilosec
- Prevacid
- Nexium
How Proton Pump Inhibitors Work
Acid is naturally produced by the stomach to help during digestion. It is produced together with other digestive fluids that are meant to remain in the stomach. The lining of the stomach is protected from exposure to acid and other digestive juices..
The lower esophageal sphincter (LES) is the valve that separates the stomach from the esophagus, allowing food to pass into the stomach while preventing digestive juices from traveling upwards. When the sphincter becomes dysfunctional, stomach acid can enter the esophagus. This is what causes acid reflux disease.
Proton pump inhibitors reduce the production of acid in the stomach by blocking the enzyme in the stomach lining that is responsible for producing acid. As long as the LES is dysfunctional, digestive fluids will travel into the esophagus. PPIs reduce acid reflux symptoms by making the fluids that reach the esophagus less irritating.
Proton pump inhibitors are typically used to:
- Prevent symptoms of acid reflux disease
- Heal inflammation and irritation in the esophagus
- Prevent complications of acid reflux disease, such as esophagitis
- Prevent and encourage treatment of ulcers
Limitations of PPIs
To effectively alleviate acid reflux Proton pump inhibitors need to be used continuously, but this form of medication is generally not advised for long-term use. Common symptoms of PPIs include chronic headaches, nausea, diarrhea and constipation, abdominal pain and skin rash.
More serious side effects and health complications can develop when PPI use is prolonged. Taking PPIs for longer than one year may significantly increase your risk for osteoporosis.
PPIs are most effective when taken 30 minutes prior to a meal. While symptoms are generally reduced, many people who use PPIs still experience some symptoms of acid reflux disease. By some estimates, more than half of those using PPIs will still experience some heartburn and reflux. Long term use of PPIs may also increase your risk for developing infections.
Using PPI medications for GERD is a lifelong strategy as the medication works only on symptoms and does not treat the underlying cause. The lifetime cost of PPI medications can be considerably higher than the cost of surgical intervention to repair the cause of the reflux.
