Many doctors inappropriately suggest people stop using PPIs for heartburn problem

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In a recent study at Michigan Medicine, researchers found that nearly 80% of doctors inappropriately recommend that their patients stop using proton pump inhibitors (PPIs) that were prescribed to prevent upper GI bleeding.

The study is published in the American Journal of Gastroenterology. The lead author is Jacob Kurlander, M.D., an assistant professor and gastroenterologist at Michigan Medicine.

PPIs are often prescribed by physicians to help patients treat symptoms like heartburn or stomach discomfort.

They also serve a role in preventing gastrointestinal bleeding in patients who have a history of ulcers or use blood thinners, like aspirin.

However, research has raised many questions about the safety of PPIs.

They have been linked to conditions like kidney disease, vitamin and mineral deficiencies, severe diarrhea, and bone fractures, although the latest high-quality evidence suggests that PPIs likely do not cause these conditions.

Physicians have been hearing a lot about the importance of cutting back on the use of PPIs because of concerns about certain possible adverse effects.

But one big question remains: Are physicians able to differentiate between patients in whom stopping the PPI is safe and those in whom it is not?

This question inspired the team to examine physicians’ recommendations for PPI-use in several different clinical situations.

The researchers invited 799 internists to complete an online survey regarding their understanding of the adverse effects and effectiveness of PPIs.

The questions were designed around topics like PPI-use for the prevention of upper GI bleeding, changes in PPI prescribing, and patient management recommendations.

They found that nearly four out of five doctors inappropriately recommended that their patients stop using PPIs that were prescribed to prevent upper GI bleeding.

They also found that physicians believe PPIs carry a substantial risk of side effects and have received the message that they should be cutting back on their use.

The findings showed that while recent professional recommendations have put a strong emphasis on using PPIs more restrictively and stopping them altogether in patients who may not need them, many internists were recommending that their patients stop taking the drug in situations where it was necessary.

The team says that physicians may be overlooking a critically important benefit of these drugs, which is the prevention of GI bleeding. PPIs are quite effective for this.

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