| [ Summary ] |
The review of the adverse effects due to prolonged PPI use (except for the articles in the first and second items of chapter 7) was done based on European and American literature since prolonged PPI use is prohibited in Japan. Adverse effects, due to prolonged PPI use were divided into two parts: those due to prolonged gastric acid suppression and those independent of effects on acid secretion. Many reports suggest that there are few problems with the latter, since observed adverse events were similar to those of other drugs without serious side effects. As to the former, the influence of hypergastrinemia and gastrointestinal bacterial overgrowth, resulting from prolonged acid suppression, must be taken into consideration. The following concerns have been raised: the possibility of increasing the risk of gastric cancer or colon cancer, increasing the risk of enteric infection and diminishing the absorption of nutrients. Current evidence suggests that prolonged acid suppression with PPI has rarely produced adverse effects, except that the absorption of vitamin B12 can be impared in some patients. Therefore, the safety of prolonged use of PPI may be considered to be established at the present. Continued follow-up of patients taking PPI for extended periods isneeded. |