Proton pump inhibitor in heartburn

Proton pump inhibitors (PPI for proton pump inhibitors) are gastric protective drugs. In the past they were prescriptions, now PPI with the active ingredients pantoprazole and omeprazole are available without prescription in pharmacies for self-medication for heartburn and acid regurgitation. In about 30 percent of the population gastric acid flows back into the esophagus (reflux). The acid gastric juice, however, irritates their unprotected mucous membrane. It ignites and is damaged. In extreme cases, even esophageal cancer can arise. Therefore, this gastric reflux into the esophagus must be prevented or at least reduced as much as possible.

Stress and high-fat foods as relevant factors

Heartburn can be caused by a flaccid sphincter at the stomach entrance or a large gap in the diaphragm. Sometimes too much stomach acid is produced. Stress as well as a high-sugar and high-fat diet play a role here.

Proton pump inhibitors are used not only against heartburn and to prevent inflammation in the esophagus, but also for the treatment and prevention of duodenal or gastric ulcer and as part of a combination therapy against the gastric bacterium Helicobacter pylori.

How omeprazole and pantoprazole work

The gastric acid is produced in the so-called parietal cells of the stomach. Active ingredients such as omeprazole and pantoprazole suppress the formation of gastric acid (dose-dependent up to 100 percent) by inhibiting a so-called "proton pump" in the parietal cells until the cells regenerate. Hence the term proton pump inhibitor.

Due to the inhibition of the mini-pumps, the production of hydrochloric acid in the stomach decreases and the acidity of the gastric juice decreases. Therefore, he is no longer so "aggressive" and any mucosal inflammations and injuries heal faster during a four- to eight-week PPI therapy.

Side effects of PPI therapy

Although proton pump inhibitors are considered effective and well tolerated. You should still be aware of any side effects. This can lead to gastrointestinal disorders such as diarrhea, fatigue, mood swings, dizziness, headaches. In rare cases, impaired vision, hearing and taste, kidney inflammation and increased liver function and blood count changes.

PPIs are suspected of favoring the development of food allergies and, especially at higher doses, favoring the colonization of the stomach with bacteria. And there are indications that they promote bone loss (osteoporosis). A high dose of proton pump inhibitor increases the risk of femoral neck fractures to double.

Furthermore, a long-term use of the gastric protective preparations can cause a chronic gastritis develops and the stomach forms after the discontinuation of the drug too much stomach acid. This can result in a PPI dependency. Furthermore, there are patients who do not respond to or insufficiently respond to PPIs.

Proper dosage and application

Omeprazole and pantoprazole are approved in adults for the short-term treatment of heartburn and acid regurgitation. Excluded are children, pregnant women and nursing women. The recommended daily dose for self-medication is an enteric-coated tablet (20 milligrams) that must not be chewed or chopped. When dosed correctly, the vital functions of the stomach acid are preserved. The doctor (!) May, however, depending on the nature and severity of the disease also advise a higher dose.

Proton pump inhibitors should not be swallowed for more than four weeks without medical attention, especially when taken for heartburn. If the symptoms do not improve after taking PPI within two weeks, a doctor's visit is also very advisable.

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