An old problem

doi:10.1136/bmj.39458.462338.3A

BMJ 2008;336:109 (19 January), doi:10.1136/bmj.39458.462338.3A

Letters

Overprescribing PPIs

An old problem

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

Forgacs and Loganayagam described the problem of overprescribingproton pump inhibitors (PPIs).¹ In June 2002 we wrote to manyjournals—and were ignored—about long term side effectsbeing identified in general practice and surgery patients, withthe then extensive, long term use of PPIs. At the time we sharedan increasing number of patients with dependence on PPIs whoexperienced acute, severe gastritis and gastro-oesophageal refluxif they suddenly stopped or missed their PPIs; some showed refractorygastroparesis and severely delayed jejuno-ileal and colonicperistalsis when trying to reduce or stop their treatment aftertaking the PPI for extended periods (>3-60 months).

PPIs block the normal homoeostasis of the gastro-jejuno-ileal-colonicfunction (owing to their very specific, acid production blockingonly, cellular-molecular actions:they block only the cellularor molecular acid production and allow secondary build up orexcessive reduction of the hormones gastrin, cholecystokinin,secretin, glucagon, motilin, VIP, substance P, somatostatin,and . . . [Full text of this article]

A Breck McKay, family physician, Daryl Wall, director of surgery

¹ PO Box 144, Carina, Qld 4152, Australia, ² Princess Alexandra Hospital, Ipswich Road, Woolloongabba, Qld 4102

mckay@bigpond.net.au