Study should not spark alarm over use of PPIs
It's important that nobody get alarmed after reading about this study. The risks are still extremely low and, in most cases, the risks of not taking prescribed medicines outweighs the risks of taking them.
All drugs potentially have side-effects and Proton Pump Inhibitors (PPI) are no exception.
However, these medicines are very useful and, used appropriately, help a great many people who either have or are at risk of ulcers, maybe because of other medicines they need to take such as anti-inflammatories or anti-coagulants, or who suffer from reflux.
The study in the BMJ Open does not seem to identify the reasons that the people were prescribed the PPI, what other medical conditions they had or what other medications they were using, so it is difficult to draw any firm conclusions.
Also, the alternative histamine H2 antagonists are not suitable for everybody because they can interact with certain other medicines.
The study appears to suggest the risks increase with long-term use.
Somebody who uses a PPI for short-term heartburn or reflux should not be at increased risk. However, it can sometimes happen that people continue to be prescribed PPIs who possibly no longer need them.
Generally, it is recommended that the lowest effective dose be used, and only for as long as necessary.
Sometimes with reflux, the underlying issue can be dealt with by lifestyle changes, such as losing weight and avoiding alcohol, smoking, caffeine and fatty foods.
We don't know the profile of the people in the study and what other illnesses they had.
In the case of the people in this study who are veterans, they could have war wounds or amputations. It could be somebody with post traumatic stress disorder who is taking other medications to treat that.
Darragh O' Loughlin is secretary general of the Irish Pharmacy Union