In the gastroenterology and oncology clinics, it is often encountered that some patients after surgery for esophageal cancer or cardia cancer come to prescribe drugs, open their mouths to prescribe palprazole drugs, such as omeprazole or rabeprazole, and complain that it is not okay not to eat, stomach acid reflux, some patients even take seven or eight years, more than ten years. On the surface, prazole drugs pharmacies and online can be bought everywhere, many people eat for many years and there is no particularly obvious side effects, many patients think that such drugs should be quite safe, in fact, prazole drugs long-term use of many side effects, is not non-toxic and harmless.
PRAZOLE drugs are collectively referred to as proton pump inhibitors, clinically also known as PPI, because they can irreversibly bind to gastric parietal cells H-K ATPase, thereby inhibiting the secretion of gastric acid, and the acid inhibition effect is powerful and long-lasting. There are many types of such drugs, both oral preparations and intravenous preparations, and there are more than ten types of oral drugs alone, which are divided into three generations. The first generation represents the drug omeprazole, the second generation represents the drug lansoprazole; the third generation represents the drugs pantoprazole and rabeprazole. Esomeprazole, a levo-isomer of omeprazole, is the most acid-suppressing of all PPIs.
Oral prazole drugs as directed are not recommended for more than 2 months, and the longest is not used for more than 3 months. When taking prazole acid suppressants for a long time, the harm is very large, mainly reflected in the following aspects.
1. It can cause atrophic gastritis
Gastric acid is indispensable in food digestion, can maintain the micro-ecological environment in the gastrointestinal tract, long-term use of proton pump inhibitors will have an impact on gastric acid secretion, some even appear local gastric mucosa atrophy, causing atrophic gastritis, less gastric acid secretion, manifested as early satiety, belching, dyspepsia, abdominal pain, bloating, constipation and so on. Atrophic gastritis is a precancerous lesion, and very few will become cancerous under the joint action of other carcinogenic factors. Long-term use of pazole drugs, a small number of patients may also appear gastric polyps, carcinoid.
2. Liver and kidney function effects
Prazole drugs are metabolized by the liver, excreted by the kidneys, and long-term use may cause elevated hepatic transaminases and alkaline phosphatase, and drug-induced liver damage may occur. There is also a certain impact on kidney function, a study in the United States showed that in five years of follow-up, more than half of patients who took PPI for a long time experienced a decrease in kidney function, which may even cause interstitial nephritis.
3. Cause osteoporosis and anemia
Prazole drugs inhibit gastric acid secretion, reduce the acidity in the stomach, reduce the absorption of calcium, long-term use can lead to calcium deficiency in the body, especially in the elderly, may increase the risk of osteoporosis and fractures. Gastric acid is a necessary condition for the absorption of iron and B vitamins, excessive inhibition of gastric acid will cause a decrease in the absorption of iron, folic acid and vitamin B12, causing iron deficiency anemia and megaloblastic anemia.
4. Increase the risk of infection
Gastric acid is a defensive barrier of the human body, long-term use of pazolium drugs, gastric acid reduction will increase the chance of infection with vancomycin-resistant enterococcus, Clostridium difficile bacteria and other bacteria, increase the risk of intestinal infection, peritonitis, pneumonia.
5. Effects of the nervous system
Long-term use of pazoles can also have an impact on the nervous system, usually manifesting as dizziness, headache, drowsiness, insomnia, depression, and irritability.
6. Affect the efficacy of other drugs
The pharmacological effects of antiplatelet drugs such as clopidogrel and aspirin may be affected by taking pazozolines, and the combination of the two drugs may increase the risk of cardiovascular adverse events. In the era of immunotherapy, it has been believed that the use of proton pump inhibitors will reduce the efficacy of PD1/PD-L1 inhibitors.
7. Mild antiandrogenic effect
Long-term medication in men may lead to breast development, impotence, and decreased libido, and long-term medication in women may lead to galactorrhea, which can return to normal after stopping the drug.
Clinically, the use of proton pump inhibitors can be said to be a bit flooded, just like the previous use of antibiotics, fortunately, at present, everyone's understanding is gradually strengthening, and medical insurance is also effectively supervising this drug field as much as possible. In patients with long-term acid reflux, substitution of tinotines (famotidine, ranitidine, etc.) may be considered during the stable phase.
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