Episode 183: Proton-pump inhibitors – the evidence for the good and the bad

In episode 183, the Mikes and James shine a bright light on the evidence around the use of proton pump inhibitors. We look at the good and bad outcomes and realize it is all about the numbers and the quality of the evidence. After 45 minutes the bright light and our knowledge starts to dim until we get to the end of the podcast when we shut the light off completely.

Show notes

1) Benefit of PPIs versus H2RA and placebo

Acute 

Cochrane Library CD003244

Chronic http://www.cks.nhs.uk/dyspepsia_proven_gord/evidence/supporting_evidence/no_response_to_initial_therapy/extending_treatment_duration#-330424

2) Prevention of NSAID –induced endoscopic ulcers

Cochrane Library CD002296

3) Stress ulcers

Crit Care Med 2010;38:1-7

4) Rebound

Gastroenterology 2009;137:80-7

5) Withdrawal

Gastroenterology 2001;121:1095–1100

Aliment Pharmacol Ther 2007;25:709–714

6) On demand use

Am J Gastroenterol 2007;102:642–653

7) Esomeprazole

Clin Gastro Hepat 2006;4:1452–8

8) Interactions

BMJ 2012;345:e4388 doi: 10.1136/bmj.e4388

9) Fractures

Drugs 2012;72:437-45

10) Pneumonia

Cleveland Clinic J Med 2011;78:39-49

11) C. difficile

Dig Dis Sci 2011;56:931–50

12) Iron and B12, and cancer

Dig Dis Sci 2011;56:931–50