PPIs and Asthma

Proton Pump Inhibitors (PPIs) Getting Bad Press: Still a Great Medicine for Asthmatics

Asthma is unfortunately a common condition (1 in 13 in U.S. populationand many people who have it also suffer from gastroesophageal refluxa digestive disease in which stomach acid or bile “refluxes” back onto the swallowing tube (esophagus) and ] irritates the lining. Reflux can be a reason for worsening asthma symptoms. What happens is acid comes up ancan spill tiny amounts into the lungs at the level of the larynx (voice box). If someone has twitchy, asthmatic lungs, this tiny bit of gastric acid in the lungs can cause acute asthma. These episodes happen most frequently at night, as we often hear people describe waking up coughing and choking in the middle of the night. 

Patient’s often complain that their asthma medications are not working for them, as they are still having symptoms. Often your board-certified allergist will decide to add reflux medicationi.e. proton pump inhibitor (PPI) to your regimen if they think reflux is triggering your asthma. Adding in this particular medication will often drastically improve symptoms without having to tweak any asthma medsWe also prescribe this medication for Eosinophilic Esophagitis (EoE) patients, an allergic/immune condition where inflammation is found in the esophagus and may cause difficulty swallowing, stomach pain, food impaction, and failure to thrive

There has been a lot of recent negative press regarding PPIs in the news media, so much so that Dr. David Johnson, Professor of Medicine and Chief Gastroenterologist at Eastern Virginia Medical School decided to take a closer look.  In his most recent article, Dr. Johnson reviews each concern that has prompted a lot of media frenzy and concern for patients on PPIs. After looking at the data closely he finds that most of the propaganda has been just that. Some of the most noted risks that have been perpetuated are concerns of dementia, osteoporosis, risks of infections and stroke. 

He cites data from several different papers and studies and breaks down each concern. He notes that many of the science or data behind these concerns is lacking thus bogus information, “[this] noise has created mayhem for patients and healthcare providers.” Bottom line, PPIs are a good medication and when taken appropriately, help many patients to feel better.

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