Prescription of proton pump inhibitors

BMJ 1999;318:534 ( 20 February )

Letters

Prescription of proton pump inhibitors

Ulcer healing drugs affect gastroscopy results

Indications may be more specific than suggested by GP records

Ulcer healing drugs affect gastroscopy results

The first 150 words of the full text of this article appear below.

EDITOR $---$ Bashford et al report a 10-fold rise in prescriptions for proton pump inhibitors between 1991 and 1995, mainly becauseof increased unlicensed use for non-ulcer dyspepsia.¹ Diagnosisof non-ulcer dyspepsia will be increased by the frequent use ofulcer healing drugs before referral for gastroscopy because thesedrugs reduce diagnostic yield.²

We audited 270 dyspeptic patients referred for gastroscopy to determine the ideal time to stop ulcer healing drugs beforeinvestigation. In all, 154 (57%) patients had taken ulcer healingdrugs in the 3 months before gastroscopy; 77 of these receivedproton pump inhibitors. When we compared patients treated withulcer healing drugs with those who had not taken these drugs inthe 3 months before gastroscopy, treated subjects had a significantlyreduced occurrence of mucosal inflammation at gastroscopy $---$ forexample, oesophagitis and peptic ulcer disease. The odds ratioof not having mucosal inflammation when ulcer healing drugs weretaken within 2 weeks of gastroscopy was . . . [Full text of this article]

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Why are patients prescribed proton pump inhibitors? Retrospective analysis of link between morbidity and prescribing in the General Practice Research Database: James N R Bashford, Jeff Norwood, and Stephen R Chapman
BMJ 1998 317: 452-456. [Abstract] [Full Text] [PDF]