Treatment of indigestion with Proton Pump Inhibitors (PPIs)
What are proton Pump Inhibitors (PPIs)?
PPIs are a type of medicine which reduce the amount of acid your stomach makes. Having less acid can help ease the symptoms of indigestion. Indigestion is also known as heartburn, dyspepsia, or acid reflux. There are a number of PPIs available for example; Omeprazole and Lansoprazole.
Not everyone with indigestion needs a PPI. Some people are prescribed PPI for other reasons such as to protect the stomach when they are prescribed anti-inflammatories, or some other medications or medical problems such as Barrett’s Oesophagus.
This information assumes that you have been medically assessed and have been prescribed a PPI for indigestion only and no other reason.
How long should I take the treatment dose of a PPI?
PPIs are usually prescribed for four to eight weeks for indigestion symptoms. They should be taken for as short a time as possible to avoid long term side effects which include:
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Increasing the risk of infections including in the bowel (Clostridium Difficile) and lungs (pneumonia).
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Reducing the absorption of important vitamins and minerals including magnesium, vitamin B12 and calcium.
However, in some instances long term PPIs are necessary but the dose may change to a lower maintenance dose. Your GP practice will advise.
For further information please see the: Endoscopy case studies - NHS Cheshire and Merseyside.
PLEASE NOTE
If indigestion does not go away after two to four weeks, you are vomiting for no obvious reason, have blood in your vomit, find it painful or difficult to swallow, are losing weight for no obvious reason or notice dark or black poo please contact your GP surgery as soon as you can, especially if you are 55 years or older.
Stopping and ‘Stepping down’ PPIs
Your dose of PPI may be changed by your GP practice to ensure that you are on the lowest dose possible for the least amount of time. This may include the following:
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Your PPI dose may be reduced
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Your PPI may only need to be taken when required for indigestion symptoms
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Your PPI may be stopped
When you ‘step down’ or stop your PPI we know that indigestion symptoms can return temporarily, sometimes worse than before. These symptoms usually settle after two to four weeks of stopping the PPI and can be managed with an antacid or alginate. Your pharmacist or GP practice will be able to advise you.
Reducing the risk of indigestion in the future
After you finish your PPI course it is important to reduce the risk of your indigestion returning through self help looking at lifestyle factors on the next page. For more patient information about indigestion, its causes and how you can manage your symptoms please visit NHS.UK.
