Mistakes in the use of PPIs and how to avoid them

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Mistakes in the use of PPIs and how to avoid them

Albert J. Bredenoord, Roos E. Pouw

Summary

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This article addresses nine common mistakes in proton pump inhibitor use and aims to clarify misconceptions about their prescription and safety.

Proton pump inhibitors, first introduced with omeprazole in 1988, revolutionized treatment of gastric acid-related conditions including gastro-oesophageal reflux disease, gastroduodenal ulcers, and Helicobacter pylori infections.
PPIs are often prescribed for conditions without a proven link to gastric acid, such as dyspepsia and upper abdominal discomfort.
Long-term PPI use has raised safety concerns including risks of vitamin and mineral malabsorption, pneumonia, gastrointestinal infections, and dementia.
Clinicians prescribing or reviewing PPI therapy would benefit from this material addressing common mistakes and misconceptions.

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This summary was generated by an AI large language model based on the content transcript. It is for informational purposes only and should not be considered a substitute for clinical judgment. Always rely on your professional expertise and the full clinical context when making clinical decisions.

References

Abstract

Proton pump inhibitors (PPIs), first introduced with omeprazole in 1988, revolutionized the treatment of gastric acid-related conditions like gastro-oesophageal reflux disease, gastroduodenal ulcers, and Helicobacter pylori infections. Despite their effectiveness, PPIs are often prescribed for conditions without a proven link to gastric acid, such as dyspepsia and upper abdominal discomfort. Long-term use of PPIs has raised safety concerns, including risks of vitamin and mineral malabsorption, pneumonia, gastrointestinal infections, and dementia. This Mistakes In article addresses nine common mistakes in PPI use and aims to clarify misconceptions about their use.

Topics

Digestive Oncology Oesophagus

Citation

Pouw R.E. and Bredenoord A.J. Mistakes in the use of PPIs and how to avoid them. UEG Education 2017; 17: 15–17.

Published

2024

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Management of gastric preneoplastic lesions (MAPS 3) - what’s new? With Mario Dinis-Ribeiro (Part 2)

Mario Dinis-Ribeiro, Pradeep Mundre

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Abstract

Topics

Stomach & H. Pylori

Published

2025

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UEG Mistakes In Articles

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Mistakes in rumination syndrome and how to avoid them

Alberto Ezquerra-Durán, Elizabeth Barba Orozco

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References

Abstract

Topics

Neurogastroenterology & Motility

Citation

Ezquerra-Durán A and Barba-Orozco E. Mistakes in rumination syndrome and how to avoid them. UEG Education 2025; 25: 10-13.

Published

2025

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Mistakes in metabolic dysfunction associated steatotic liver disease and how to avoid them

Sarah Townsend, Philip Newsome

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References

Abstract

Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) is a subclassification of steatotic liver disease (SLD), defined as the presence of excess triglyceride storage in the liver in conjunction with at least one cardiometabolic risk factor and no other discernible cause.1 Cirrhosis secondary to MASH is the most common cause of liver disease in the world and is the fastest-growing indication for liver transplantation, but it also has a >50% recurrence rate post-transplantation.

Topics

Hepatobiliary

Citation

Townsend SA and Newsome PN. Mistakes in nonalcoholic fatty liver disease and how to avoid them. UEG Education 2017; 17: 39–41.

Published

2024

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UEG Mistakes In Articles

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Mistakes in hepatitis C and how to avoid them

Ana Catarina Garcia, Gonçalo Alexandrino

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Abstract

Hepatitis C virus (HCV) infection remains an important global health concern. It is estimated that there are approximately 50 million people infected with HCV globally, with around 1 million new infections each year and about 242,000 deaths annually attributed to HCV-related complications. Most acute HCV infections (55–85%) become chronic due to the virus’s effective evasion strategies, with spontaneous clearance being rare once chronicity is established. This condition often progresses silently, with many individuals unaware of their infection until advanced liver damage has occurred. If left untreated, HCV can lead to severe complications, including liver cirrhosis and hepatocellular carcinoma (HCC). HCV transmission occurs mainly through percutaneous exposure to infected blood. HCV can also spread from mother to infant (vertical transmission) and, less frequently, via sexual contact.1,2 In recent years, the introduction of oral direct-acting antivirals (DAAs), with remarkable safety and effectiveness profiles, has led to a sustained virological response (SVR) in virtually all (>97%) HCV-infected patients, regardless of HCV genotype or disease stage. However, significant barriers remain, such as issues with diagnosis, access to treatment and awareness of the disease.

Here, we discuss some of the misconceptions in HCV management and provide a practical management approach grounded in evidence and clinical experience.

Topics

Hepatobiliary

Citation

Garcia A.C and Alexandrino G. Mistakes in hepatits C and how to avoid them. UEG Education 2025; 25: 14-17.

Published

2025

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UEG Standards and Guidelines

Clinical Practice Guideline

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Diagnosis of chronic anaemia in gastrointestinal disorders: A guideline by the Italian Association of Hospital Gastroenterologists and Endoscopists (AIGO) and the Italian Society of Paediatric Gastroenterology Hepatology and Nutrition (SIGENP)

Luca Elli, Lorenzo Norsa, Angelo Zullo, Antonio Carroccio, Carlo Maria Girelli, Salvatore Oliva, Claudio Romano, Gioacchino Leandro, Massimo Bellini, Riccardo Marmo, Marco Soncini, Fabio Monica, Vincenzo De francesco, Emma Paulon, Maria Domenica Cappellini, Irene Motta, Francesca Ferretti, Stefania Orlando, Pasquale Mansueto, Elisabetta Buscarini, Guido Manfredi, Carlo Agostoni, Carolina Tomba, Renato Cannizzaro

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Guideline

Summary

Anaemia is a common pathologic condition, present in almost 5% of the adult population. Iron deficiency is the most common cause; other mechanisms can be involved, making anaemia a multi-factorial disorder in most cases. Anaemia being a frequent manifestation in the diseases of the gastrointestinal tract, patients are often referred to gastroenterologists. Furthermore, upper and lower endoscopy and enteroscopy are pivotal to the diagnostic roadmap of anaemia. In spite of its relevance in the daily clinical practice, there is a limited number of gastroenterological guidelines dedicated to the diagnosis of anaemia. For this reason, the Italian Association of Hospital Gastroenterologists and Endoscopists and the Italian Society of Paediatric Gastroenterology, Hepatology and Nutrition commissioned a panel of experts to prepare a specific guideline on anaemia and its diagnostic roadmap in the gastroenterological scenario. The panel also discussed about the potential involvement of gastroenterologists and endoscopists in the management of patients with anaemia, with particular attention to the correct use of investigations. The panel paid particular attention to practical issues with the aim to support gastroenterologists in their clinical practice when dealing with patients with anaemia.

Keywords: anaemia; celiac disease; endoscopy; H. pylori; inflammatory bowel disease; iron deficiency; small bowel

Guideline

Clinical Practice Guideline

Topics

Digestive Oncology Endoscopy IBD Paediatrics Primary Care Radiology & Imaging Small Intestine & Nutrition Stomach & H. Pylori

Citation

Dig Liver Dis. 2019 Apr;51(4):471-483

Published

2019

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UEG Online Courses x UEG Podcast: Impact of polyp detection in colonoscopy

Raf Bisschops, Manuele Furnari, Pieter Sinonquel, Veronique Van der Voort

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Abstract

Topics

Endoscopy

Published

2026

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