Dear Editor,
Proton Pump mechanism seems to be ubiquitous in nature in general and the human body, its various tissues and its microbiome. So it is possible that Proton Pump Inhibitors (PPIs) may affect many tissues beyond their intended effects. In fact there are many articles on this subject.
Every time a person has abdominal discomfort, it may not be due to excessive gastric acid secretion. It is also as if any medicine prescribed may cause abdominal discomfort. It is not as if co-prescription of PPI will prevent or reduce abdominal discomfort caused by other medicines. Yet it is common to find PPIs prescribed to prevent or reduce abdominal discomfort.
The unintended effects of PPIs on other tissues are often likely to be subtle and set in insidiously.
It has been often found that certain medications were being prescribed very enthusiastically only to be found later that their use could or should have been avoided.
For some reason I felt alarmed, quite some years ago, that a wide use of PPIs may not be warranted or rather should be avoided. Hence I tried to keep the medicines down to the minimum in my prescriptions, and avoid co-prescription of PPIs. It was often seen that not coprescribing PPI had not harmed people in any way.
I use PPIs sparingly.
Arvind Joshi,
MBBS MD FCGP FAMS FICP.
Point to Ponder Re: Reduce unnecessary use of proton pump inhibitors