Use and Abuse of Anti-Ulcerants: A Perspective from Bangladesh

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Brief description: Proton pump inhibitors (PPIs) is a time-tested  drug for effective suppression of gastric acid and is indicated in several upper gastrointestinal disorders . These drugs irreversibly inhibit the gastric H+, K+ ATPase pump and reduce both basal and stimulated gastric acid output [2]. They are shown to be effective in the treatment of gastro-esophageal reflux disease (GERD), peptic ulcers, and dyspepsia . Along with antibacterial, they are used for the  eradication of Helicobacter pylori [ 7]. PPIs are also prescribed as a concomitant medication to prevent non-steroidal anti-inflammatory drug (NSAID) associated ulcers in high-risk patients and also patients who receive Glucocorticoid for prolonged duration [8]. There are two main indications for long-term use of PPIs are reflux disease and use of maintenance non-steroidal anti-inflammatory drugs (NSAIDs), which puts patients at risk for non-steroidal gastropathy. Except for hyper secretory states, which are very rare disorders, most other indications for acid suppression do not require years and years of PPI exposure [9].