Lynchburg Journal of Medical Science

Lynchburg Journal of Medical Science




Dr. Tom Colletti, DHSc, PA-C, DFAAPA



Purpose: The purpose of this article is to review the suggested adverse events that has been associated with long-term proton pump inhibitor (PPI) use and gain clarity about their true association.

Methods: A MEDLINE literature search was conducted with search terms proton pump inhibitors, long-term use, side effects, or adverse effects limited to the last five years. Two hundred seventy-two pertinent articles were retrieved. Only the articles mentioning chronic kidney disease (CKD), dementia, fractures, and Clostridium difficile infection (CDI) served as the basis for this clinical review. Studies were limited to systemic reviews, meta-analysis, and prospective case-control studies.

Results: A research of the literature revealed mostly retrospective studies which suggest adverse events such as CKD, dementia, fractures, and CDI have a link to long-term PPI use. With a review of the limited prospective case control studies available, caution should be used before giving a complete causal relationship to these suggested adverse events with long-term PPI use. More prospective randomized trials are needed to provide these connections.

Conclusion: Proton pump inhibitors have proven to be effective in the management of gastroesophageal reflux disease (GERD) since they were introduced in the late 1980s. Based on current research, caution should be used in drawing conclusions on the suggested PPI-associated adverse events. Therefore, PPIs should continue to have an appropriate place in clinical medicine with guarded use around certain patient populations or comorbidities.


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