Editing Proton-pump inhibitor (section)

== Medical uses ==
These medications are used in the treatment of many conditions, such as:
* [[Dyspepsia]]<ref name="Overview">{{cite journal| vauthors = Zajac P, Holbrook A, Super ME, Vogt M |title=An overview: Current clinical guidelines for the evaluation, diagnosis, treatment, and management of dyspepsia|journal=Osteopathic Family Physician |volume=5 |issue=2 |pages=79–85 |date=March–April 2013 |doi=10.1016/j.osfp.2012.10.005}}</ref><ref name="pmid17174612">{{cite journal | vauthors = Wang WH, Huang JQ, Zheng GF, Xia HH, Wong WM, Liu XG, Karlberg J, Wong BC | title = Effects of proton-pump inhibitors on functional dyspepsia: a meta-analysis of randomized placebo-controlled trials | journal = Clinical Gastroenterology and Hepatology | volume = 5 | issue = 2 | pages = 178–85; quiz 140 | date = February 2007 | pmid = 17174612 | doi = 10.1016/j.cgh.2006.09.012 | doi-access =  }}</ref>
* [[Peptic ulcer]] disease including after endoscopic treatment for bleeding<ref name="pmid25201154">{{cite journal | vauthors = Sachar H, Vaidya K, Laine L | title = Intermittent vs continuous proton pump inhibitor therapy for high-risk bleeding ulcers: a systematic review and meta-analysis | journal = JAMA Internal Medicine | volume = 174 | issue = 11 | pages = 1755–62 | date = November 2014 | pmid = 25201154 | pmc = 4415726 | doi = 10.1001/jamainternmed.2014.4056 | doi-access = free }}</ref>
* As part of ''[[Helicobacter pylori]]'' eradication therapy<ref name="pmid24338763">{{cite journal | vauthors = Yuan Y, Ford AC, Khan KJ, Gisbert JP, Forman D, Leontiadis GI, Tse F, Calvet X, Fallone C, Fischbach L, Oderda G, Bazzoli F, Moayyedi P | title = Optimum duration of regimens for Helicobacter pylori eradication | journal = The Cochrane Database of Systematic Reviews | volume = 12 | issue = 12 | pages = CD008337 | date = December 2013 | pmid = 24338763 | doi = 10.1002/14651858.CD008337.pub2 | doi-access =  | pmc = 11841770 }}</ref>
* [[Gastroesophageal reflux disease]] (GERD or GORD) including symptomatic endoscopy-negative reflux disease<ref name="pmid23728637">{{cite journal | vauthors = Sigterman KE, van Pinxteren B, Bonis PA, Lau J, Numans ME | title = Short-term treatment with proton pump inhibitors, H2-receptor antagonists and prokinetics for gastro-oesophageal reflux disease-like symptoms and endoscopy negative reflux disease | journal = The Cochrane Database of Systematic Reviews | volume = 5 | issue = 5 | pages = CD002095 | date = May 2013 | pmid = 23728637 | pmc = 7066537 | doi = 10.1002/14651858.CD002095.pub5 | doi-access = free }}</ref> and associated [[laryngopharyngeal reflux]] causing [[laryngitis]]<ref name="pmid17037995">{{cite journal | vauthors = Qadeer MA, Phillips CO, Lopez AR, Steward DL, Noordzij JP, Wo JM, Suurna M, Havas T, Howden CW, Vaezi MF | title = Proton pump inhibitor therapy for suspected GERD-related chronic laryngitis: a meta-analysis of randomized controlled trials | journal = The American Journal of Gastroenterology | volume = 101 | issue = 11 | pages = 2646–54 | date = November 2006 | pmid = 17037995 | doi = <!-- Do not add one until it actually works.  The journal changed locations, and it goes to Nature.com right now --> | doi-broken-date = <!-- Deny Citation Bot --> }}</ref> and [[chronic cough]]<ref name="pmid16330475">{{cite journal | vauthors = Chang AB, Lasserson TJ, Kiljander TO, Connor FL, Gaffney JT, Garske LA | title = Systematic review and meta-analysis of randomised controlled trials of gastro-oesophageal reflux interventions for chronic cough associated with gastro-oesophageal reflux | journal = BMJ | volume = 332 | issue = 7532 | pages = 11–7 | date = January 2006 | pmid = 16330475 | pmc = 1325125 | doi = 10.1136/bmj.38677.559005.55 | doi-access = free }}</ref>
* [[Barrett's esophagus]]<ref name="pmid24221456">{{cite journal | vauthors = Singh S, Garg SK, Singh PP, Iyer PG, El-Serag HB | title = Acid-suppressive medications and risk of oesophageal adenocarcinoma in patients with Barrett's oesophagus: a systematic review and meta-analysis | journal = Gut | volume = 63 | issue = 8 | pages = 1229–37 | date = August 2014 | pmid = 24221456 | pmc = 4199831 | doi = 10.1136/gutjnl-2013-305997 }}</ref>
* [[Eosinophilic esophagitis]]<ref name="pmid26247167">{{cite journal | vauthors = Lucendo AJ, Arias Á, Molina-Infante J | title = Efficacy of Proton Pump Inhibitor Drugs for Inducing Clinical and Histologic Remission in Patients With Symptomatic Esophageal Eosinophilia: A Systematic Review and Meta-Analysis | journal = Clinical Gastroenterology and Hepatology | volume = 14 | issue = 1 | pages = 13–22.e1 | date = January 2016 | pmid = 26247167 | doi = 10.1016/j.cgh.2015.07.041 | doi-access = free }}</ref>
* Stress [[gastritis]] and ulcer prevention in [[critical care medicine|critical care]]<ref name="pmid23318494">{{cite journal | vauthors = Alhazzani W, Alenezi F, Jaeschke RZ, Moayyedi P, Cook DJ | title = Proton pump inhibitors versus histamine 2 receptor antagonists for stress ulcer prophylaxis in critically ill patients: a systematic review and meta-analysis | journal = Critical Care Medicine | volume = 41 | issue = 3 | pages = 693–705 | date = March 2013 | pmid = 23318494 | doi = 10.1097/CCM.0b013e3182758734 | s2cid = 8138473 }}</ref>
* [[Gastrinoma]]s 
* [[Zollinger–Ellison syndrome]] (often 2–3× the regular dose is required)<ref name="pmid24319020">{{cite journal | vauthors = Epelboym I, Mazeh H | title = Zollinger-Ellison syndrome: classical considerations and current controversies | journal = The Oncologist | volume = 19 | issue = 1 | pages = 44–50 | date = January 2014 | pmid = 24319020 | pmc = 3903066 | doi = 10.1634/theoncologist.2013-0369 }}</ref>

Specialty professional organizations recommend that people take the lowest effective PPI dose to achieve the desired therapeutic result when used to treat gastroesophageal reflux disease long-term.<ref name="AGAfive">{{cite web |title=Five Things Physicians and Patients Should Question |date=24 February 2015 |publisher=[[American Gastroenterological Association]] |url=http://www.choosingwisely.org/doctor-patient-lists/american-gastroenterological-association/}}</ref><ref name="refluxstate">{{cite journal | vauthors = Kahrilas PJ, Shaheen NJ, Vaezi MF, Hiltz SW, Black E, Modlin IM, Johnson SP, Allen J, Brill JV | title = American Gastroenterological Association Medical Position Statement on the management of gastroesophageal reflux disease | journal = Gastroenterology | volume = 135 | issue = 4 | pages = 1383–1391, 1391.e1-5 | date = October 2008 | pmid = 18789939 | doi = 10.1053/j.gastro.2008.08.045 | doi-access = free }}</ref><ref name="doi/10.1136/bmj.l1580" /> In the United States, the [[Food and Drug Administration]] (FDA) has advised that over-the-counter PPIs, such as Prilosec OTC, should be used no more than three 14-day treatment courses over one year.<ref name="fda" /><ref name="FDA magnesium" />

Despite their extensive use, the quality of the evidence supporting their use in some of these conditions is variable. The effectiveness of PPIs has not been demonstrated for every case. For example, although they reduce the incidence of [[esophageal adenocarcinoma]] in Barrett's oesophagus,<ref name="pmid24221456" /> they do not change the length affected.<ref name="pmid16556174">{{cite journal | vauthors = Cooper BT, Chapman W, Neumann CS, Gearty JC | title = Continuous treatment of Barrett's oesophagus patients with proton pump inhibitors up to 13 years: observations on regression and cancer incidence | journal = Alimentary Pharmacology & Therapeutics | volume = 23 | issue = 6 | pages = 727–33 | date = March 2006 | pmid = 16556174 | doi = 10.1111/j.1365-2036.2006.02825.x | s2cid = 6969621 | doi-access = free }}</ref> In addition, research in the UK has suggested that PPIs are not effective at treating persistent throat symptoms.<ref>{{cite journal |date=2022-01-13 |title=PPIs should not be prescribed for throat symptoms |url=https://evidence.nihr.ac.uk/alert/throat-symptoms-should-not-be-treated-with-ppis/ |access-date=2022-07-06 |website=NIHR Evidence |doi=10.3310/alert_48810 |s2cid=245960803 |language=en-GB}}</ref><ref>{{cite journal |last1=Wilson |first1=Janet A. |last2=Stocken |first2=Deborah D. |last3=Watson |first3=Gillian C. |last4=Fouweather |first4=Tony |last5=McGlashan |first5=Julian |last6=MacKenzie |first6=Kenneth |last7=Carding |first7=Paul |last8=Karagama |first8=Yakubu |last9=Harries |first9=Meredydd |last10=Ball |first10=Stephen |last11=Khwaja |first11=Sadie |date=2021-01-22 |title=Lansoprazole for persistent throat symptoms in secondary care: the TOPPITS RCT |journal=Health Technology Assessment |language=EN |volume=25 |issue=3 |pages=1–118 |doi=10.3310/hta25030 |pmid=33492208 |pmc=7869007 |s2cid=231702049 |issn=2046-4924|doi-access=free }}</ref>

===Indications for stopping PPIs===
PPIs are often used longer than necessary. In about half of people who are hospitalized or seen at a primary care clinic there is no documented reason for their long-term use of PPIs.<ref name=Far2017>{{cite journal | vauthors = Farrell B, Pottie K, Thompson W, Boghossian T, Pizzola L, Rashid FJ, Rojas-Fernandez C, Walsh K, Welch V, Moayyedi P | title = Deprescribing proton pump inhibitors: Evidence-based clinical practice guideline | journal = Canadian Family Physician | volume = 63 | issue = 5 | pages = 354–364 | date = May 2017 | pmid = 28500192 | pmc = 5429051 }}</ref> Some researchers believe that, given the little evidence of long-term effectiveness, the cost of the medication and the potential for harm means that clinicians should consider stopping PPIs in many people.<ref>{{cite journal|date=August 2014|title=Canadian Cardiovascular Society and Choosing Wisely Canada: The Road to Creating a List of Five Things Physicians and Patients Should Question|journal=Canadian Journal of Cardiology|volume=30|issue=8|pages=949–955|doi=10.1016/j.cjca.2014.06.010|issn=0828-282X}}</ref>