Is it risky to use stomach medications? What are the Important Side Effects?
Stomach medications play an important role in managing stomach-related issues.
What are proton pump inhibitors (PPIs)?
omeprazole, esomeprazole, lansoprazole, dexlansoprazole, pantoprazole, rabeprazole
İçindekiler
They were first introduced over two decades ago, but have quickly become a cornerstone treatment for stomach-related ailments. They were accepted for their superior antisecretory properties and apparently low side effects, thus their prescribing has increased tremendously [1].
They have become first-line therapy for esophagitis, gastroesophageal reflux disease (GERD), peptic ulcer disease (PUD), and Helicobacter pylori (H. pylori) infection [2].
They were first introduced over two decades ago, but have quickly become a cornerstone treatment for stomach-related ailments. They were accepted for their superior antisecretory properties and apparently low side effects, thus their prescribing has increased tremendously [1].
They have become first-line therapy for esophagitis, gastroesophageal reflux disease (GERD), peptic ulcer disease (PUD), and Helicobacter pylori (H. pylori) infection [2].
Many patients who started stomach medication continued for a long period of time, with no clear expectation of the duration of treatment. The increasing number of patients on long-term stomach medication has led to growing concerns about medication side effects. In particular, some reports have claimed that inappropriate long-term use of PPIs has increased significantly over the past decade, with some data suggesting that only half of patients receiving proton pump inhibitor therapy are undergoing appropriate treatment.
Possible harms of proton pump inhibitors, which are stomach medications
Proton Pump Inhibitors are the most commonly prescribed stomach medications for various stomach disorders worldwide. The safety of proton pump inhibitors for male sexuality in long-term use is not fully known.
In one study, a significant difference was found in male patients using proton pump inhibitors regularly for 3 months in terms of sex hormone binding hormone, total testosterone, decreased libido and erectile dysfunction, and a decrease in the amount of semen. Prolactin levels have also been elevated.
https://pubmed.ncbi.nlm.nih.gov/36626934/
Vitamin and mineral malabsorption
It has been shown in many studies that PPIs can cause B12, iron, and magnesium deficiencies.
Hypocalcemia/risk of fracture
Calcium salts, such as calcium carbonate, require a highly acidic environment for absorption. Stomach medications block acid production and consequently prevent the absorption of calcium carbonate. Calcium malabsorption increases the risk of osteoporosis and subsequent bone fractures.
Kidney disease
In recent studies, it has been noted that proton pump inhibitors are associated with the development of acute kidney injury (AKI) and subsequent chronic kidney disease (CKD).
Dementia
It is thought that proton pump inhibitors increase the production of β-amyloid plaques and increase the affinity of tau proteins to brain tissue. Both processes are key in the pathogenesis of Alzheimer's Disease [40]. A systematic review revealed that the risk of dementia increased 1.4 times with the use of PPIs. However, one of the studies showed a negative correlation [49].
Gastrointestinal Infections
It is thought that proton pump inhibitors alter the intestinal microbiota and, as a result, may predispose patients to gastrointestinal infections [51, 52]. A systematic review and meta-analysis of 56 studies found that PPI therapy increased the risk of Clostridium difficile (C. difficile) infection [53].
Pneumonia risk
Proton pump inhibitors are thought to increase bacterial colonization in the stomach and cause lung micro-aspiration events or cause lung infections by changing the respiratory flora [57, 58].
Gastric cancer
There is an increasing number of studies indicating the association of chronic PPI therapy with gastric cancer [61–63]. Decreased acid production and subsequent hypergastrinemia can cause hyperplasia of enterochromaffin-like (ECL) cells [35, 64].
If you develop sexual dysfunctions such as erectile dysfunction, sexual reluctance, loss of hardness during sexual intercourse, and premature ejaculation after starting the use of stomach medications, you should definitely consult your doctor. These medications not only directly contribute to erectile dysfunction but also cause vitamin and mineral absorption disorders, further exacerbating erectile dysfunction.
