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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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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Abstract

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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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UEG Podcast Episode

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Coeliac disease with David Sanders

David S. Sanders, Pradeep Mundre

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Abstract

Topics

Small Intestine & Nutrition

Published

2026

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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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MASLD with Sven Francque - Part 2

Sven Francque, Pradeep Mundre

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Abstract

Topics

Hepatobiliary

Published

2026

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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 Mistakes In Articles

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Mistakes in gastroparesis and how to avoid them

Asma Fikree

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Abstract

The term ‘gastroparesis’ was first coined by Kassander in 1958 to describe the fact that barium did not leave the stomach of patients with diabetes for over 24 hours — so-called ‘gastroparesis diabeticorum’. Nowadays it refers to a delay in gastric emptying that is associated with symptoms primarily of nausea and vomiting as well as the absence of mechanical obstruction. In 1958, 21 cases were described, but in 2019, 5 million US individuals were diagnosed as having gastroparesis. This rapid increase in prevalence is likely to have occurred because it has become much easier to measure gastric emptying and to attribute symptoms to this without necessarily thinking through differentials. The incidence of hospital admissions for patients labelled as having gastroparesis is rapidly rising, increasing at a much faster rate than admissions for patients with nausea and vomiting, gastro-oesophageal reflux disease, gastritis or gastric ulcers, which are all remaining relatively static. Gastroparesis therefore represents a major healthcare burden. Gastroparesis can be idiopathic or is most frequently caused by diabetes (type 1 more than type 2) or surgical procedures that can disrupt the vagus nerve (e.g. Billroth gastrectomy, oesophagectomy, gastric bypass surgery and fundoplication). In this article, I describe the mistakes most frequently made in patients who have a suspected diagnosis of gastroparesis. I base my discussion on the available evidence as well as clinical experience in the field.

Topics

Neurogastroenterology & Motility Stomach & H. Pylori

Citation

Fikree A. Mistakes in gastroparesis and how to avoid them. UEG Education 2021; 21: 18–22.

Published

2021

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