Effect of proton pump inhibitors

introduction

Proton pump inhibitors are approved in Germany and other countries for certain diseases that can be regulated by reducing stomach acid. Proton pump inhibitors are frequently used in diagnoses such as gastric and intestinal ulcers, stomach burns, reflux disease, Helicobacter pylori eradication (together with antibiotics) and in Zollinger-Ellison syndrome.

They are also often prescribed together with so-called NSAIDs (painkillers such as acetylsalicylic acid, ibuprofen, diclofenac) and in these cases should act as "stomach protection", i.e. to protect against bleeding from the mucous membrane in the stomach.

Mode of action

The stomach acid has in healthy people, depending on how long the last Enjoy the meal is back, one PH value from 1-1.5 (sober) and 2-4 (full stomach). The stomach acid represents an essential part of the digestion and the the body's defenses Only through them can certain foods, especially Proteins, be digested and bacteria be fought off early.

In certain cases it may be that Increased stomach acid produced and overall gastric juice is too acidic. In addition, the acid is annoying when it comes through a Sphincter weakness in the esophagus arrives (Reflux, Symptom: heartburn).
Come with these diagnoses Proton pump inhibitors used to reduce the acidity of gastric juice.

Are proton pump inhibitors Medication, which in Germany under the name Omeprazole, Lansoprazole, Pantoprazole, Rabeprazole and the Esomeprazole are sold. Paradoxically, the active ingredients of these drugs must be in one acid-proof capsule be packed so that they are not destroyed by gastric juice. The active ingredient is only absorbed when the tablet has passed the stomach and is in the Duodenum is located. The substances are so-called “prodrugs” because they are only converted into their active form at their destination, the parietal cells of the stomach.

In the Parietal cell (Parietal cell) of the stomach there is a transporter that transports hydrogen ions in exchange with potassium ions into the inside of the stomach. Inside the stomach, the hydrogen ions are used to form hydrochloric acid with chloride ions, which is the acid in gastric juice. This van is often too Proton pump called.
The transporter is also the Place of action of the proton pump inhibitor. After the active ingredient in Small intestine was absorbed, and about that blood has reached the parietal cells of the stomach, it irreversibly inhibits this proton pump. This means that the jammed vans do not resume their work, but new proton pumps built to get hydrogen ions into the stomach and to make stomach acid. However, a day will be about one third of the existing proton pumps formed anewso that the irreversible inhibition cannot cause an absolute, long-lasting acid deficiency. This can reduce the total acid content in the stomach through proton pump inhibitors efficiently lowered become. The approximate pH of the gastric juice increases with the use of proton pump inhibitors to about 3-4 when sober. Due to the firm binding to the parietal cell and the long duration of action of the substance, one tablet a day is sufficient in most cases, although it should be noted that the onset of action of the medication is usually sufficient only completed after a day is. It is usually recommended that the medication about half an hour before a meal be taken.

Depending on the disease, therapy with proton pump inhibitors is recommended recommended for different lengths. So are patients who usually complain of heartburn within a few days symptom-free, and can then initially only take the drug if the symptoms recur. The healing processes for other diseases may take significantly longer. So it is recommended that a Gastric ulcer or one Esophagitis the proton pump inhibitor up to 6 weeks should be taken.

Side effects

As with most medications are also with Proton pump inhibitors Side effects have been described and observed.

Frequently are stomach pain and nausea, but can also be used with long-term use serious illnesses arise, as well as frequent Broken bones and severe infections with bacteria. The reason for this is the increase in the pH level in the gastric juice, as it causes bacteria survive much easier and can cause severe gastrointestinal infections. In addition, calcium can no longer be easily absorbed, which is the case bone harms. Older people as well as children are significantly more at risk from these side effects.

New scientific studies have found that the administration of proton pump inhibitors tends to be too frequent, and especially arranged too long becomes. So are partly the drugs as stomach protection taking some painkillers at the same time prescribed, and then not stopped after stopping the pain reliever. Since the main effect is no longer necessary in these cases, the side effects clearly predominate.