ADVERSE EFFECT OF PPIs IN GASTRO DISEASES IS MORE A FAKE NEWS THAN A FACT

ADVERSE EFFECT OF PPIs IN GASTRO DISEASES IS MORE A FAKE NEWS THAN A FACT 

Prof.Dr.Dram,profdrram@gmail.com,Gastro Intestinal,Liver Hiv,Hepatitis and sex diseases expert 7838059592,9434143550

 Proton pump inhibitors (PPIs) are well tolerated and effective. Despite the ever-increasing number of associations and the widespread media coverage the quality of the evidence linking PPIs to a wide range of serious adverse effects is very low. When PPIs are prescribed appropriately, the benefits greatly outweigh potential adverse effects.The study has been published in a reuted journal " Curr Opin Gastroenterol. "

             The absolute risk to an individual is extremely low (less than 1 in 500) and fear of these risks should not dictate prescribing habits. PPIs should be prescribed for patients with GERD, especially those with erosive esophagitis and strictures, as well as for patients at an increased risk for ulcer-related bleeding from NSAIDs, aspirin, and dual antiplatelet therapies. In those patients without a valid indication, PPIs should be discontinued.

        Most of the recent highly publicized serious adverse effects ascribed to proton pump inhibitors are not based on demonstrable evidence.Not only has the information derived from these observational studies been unhelpful, but also the unattended consequence is that patients who require PPIs to prevent UGI bleeding are not receiving these medications, mainly due to fear on the part of the patient and provider. Now, investigators must sell their research in order to get published and funded, and journals are more than willing to publish controversial less than optimally executed studies in an effort to improve their impact factor.

            Although one may argue that these studies, with overstated conclusions that imply but cannot demonstrate cause and effect, ought not to be published, perhaps it can be more strongly argued that, if published, authors must be mandated to strongly indicate that such associations are weak and more likely to be caused by confounding variables both in the study itself and media interviews, conclusions should be tempered and derived the data without added hyperbole, articles should not be published, especially in high impact journals, for the sake of publicity for the journal, and editorials should accompany the papers that place the findings in appropriate context and caution about misinterpretation. When PPIs are prescribed long-term, they should be used at the lowest effective doses and the need for their use should be periodically reassessed.