Abstract |
Concerns have been raised regarding the safety of proton pump inhibitors in the long-term management of acid-related peptic disease, especially with regard to the physiological effects of prolonged hypochlorhydria. Of special consideration is the potential for development of enterochromaffin-like cell hyperplasia and gastric carcinoids, colorectal adenocarcinoma and polyps, and bacterial overgrowth as a result of achlorhydria. However, the magnitude of hypergastrinemia associated with the administration of proton pump inhibitors is comparable to that observed after vagotomy and is 3- to 6-fold lower than that observed with pernicious anemia. Only minimal morphological changes in gastric endocrine cells have been observed after the long-term daily administration of proton pump inhibitors, and these changes appear to be self-limiting, nondysplastic, and nonneoplastic. All current evidence suggests that the hypergastrinemia observed during proton pump inhibitor therapy has little clinical significance. However, longer-term results are necessary so that one can appreciate the full implications of acid suppression by proton pump inhibitors.
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Authors | J W Freston |
Journal | The American journal of gastroenterology
(Am J Gastroenterol)
Vol. 92
Issue 4 Suppl
Pg. 51S-55S; discussion 55S-57S
(Apr 1997)
ISSN: 0002-9270 [Print] United States |
PMID | 9127627
(Publication Type: Journal Article, Review)
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Chemical References |
- Antacids
- Anti-Ulcer Agents
- Gastrins
- Histamine H2 Antagonists
- Proton Pump Inhibitors
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Topics |
- Antacids
(adverse effects, therapeutic use)
- Anti-Ulcer Agents
(therapeutic use)
- Drug Interactions
- Gastrins
(blood)
- Histamine H2 Antagonists
(therapeutic use)
- Humans
- Peptic Ulcer
(blood, drug therapy, microbiology)
- Proton Pump Inhibitors
- Safety
- Time Factors
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