Proton Pump Inhibitor Use and Incident Cardiovascular Disease in Older Postmenopausal Women DOI Open Access
Ahmed Soliman, Jean Wactawski‐Wende, Amy E. Millen

et al.

Journal of the American Geriatrics Society, Journal Year: 2024, Volume and Issue: unknown

Published: Dec. 31, 2024

ABSTRACT Background Epidemiological studies have been inconsistent regarding an association between proton pump inhibitor (PPI) use and risk of primary cardiovascular disease (CVD) events. Methods We studied 85,189 postmenopausal women (mean age 63 years at baseline) without known CVD enrollment into the Women's Health Initiative Observational Study (1993–1998). PPI was determined from medication inventories baseline Year‐3. events were physician adjudicated defined as a composite coronary heart disease, stroke, mortality. Follow up to September 2010. Multivariable Cox proportional hazard models used estimate ratios (HR) 95% confidence intervals (CI) for incident according (no/yes), duration (non‐user, < 1 year, 1–3 years, > 3 years), time‐varying based on updated Year‐3 information. Propensity score adjustment control residual confounding. Results At baseline, 1747 (2.1%) reported using PPIs. During mean follow‐up 11 5778 (6.8%) cases identified. users had significantly higher compared with non‐users in fully adjusted model (HR: 1.21, CI: 1.02–1.43), after propensity 1.27, 1.21–1.32). Longer associated incrementally (HRs: year: 1.11, years: 1.33; p trend = 0.02). Conclusions older women. These findings underscore importance guideline‐directed avoid unwanted adverse

Language: Английский

Rebound Acid Hypersecretion after Withdrawal of Long-Term Proton Pump Inhibitor (PPI) Treatment—Are PPIs Addictive? DOI Open Access
Ken Namikawa, Einar S. Björnsson

International Journal of Molecular Sciences, Journal Year: 2024, Volume and Issue: 25(10), P. 5459 - 5459

Published: May 17, 2024

Proton pump inhibitors (PPIs) are widely used in the long-term treatment of gastroesophageal reflux disease (GERD) and other upper gastrointestinal disorders, such as healing peptic ulcers and/or prophylactic ulcers. PPIs also symptomatic patients with functional dyspepsia. One adverse effects use PPI is rebound acid hypersecretion (RAHS), which can occur after withdrawal therapy due to a compensatory increase gastric production. Mechanisms RAHS have been well established. Studies shown that pentagastrin-stimulated secretion discontinuation increased significantly compared before treatment. In healthy volunteers treated PPIs, latter induced symptoms 40–50% subjects but stopping placebo. It important for practicing physicians be aware understand underlying mechanisms inform about potential discontinuing order avoid continuing unnecessary therapy. This because may lead reuptake incorrectly thought originate from recurrence conditions, GERD. established; however, clinical implications risk factors not fully understood. Further research needed facilitate appropriate management future.

Language: Английский

Citations

4
Pharmacological management of gastro-esophageal reflux disease: state of the art in 2024 DOI
Pierfrancesco Visaggi, Luisa Bertin, Andrea Pasta

et al.

Expert Opinion on Pharmacotherapy, Journal Year: 2024, Volume and Issue: 25(15), P. 2077 - 2088

Published: Oct. 11, 2024

Introduction Gastroesophagealreflux disease (GERD) is a chronic of the esophagus characterized bythe regurgitation stomach contents into causing troublesomesymptoms and/or complications. Among patients with GERD, around 30% patientshave visible mucosal damage, while 70% have normal esophageal mucosa. Accordingly,the optimal pharmacological treatment GERD should address different diseasemanifestations, including symptoms, damage when present, and possiblechronic complications, strictures, Barrett's esophagus, andesophageal adenocarcinoma.

Language: Английский

Citations

4
Recomendaciones de buena práctica clínica en la prescripción y deprescripción de inhibidores de la bomba de protones. Revisión por expertos de la AMG DOI Creative Commons
Luis R. Valdovinos-García,

A.S. Villar-Chávez,

F.M. Huerta-Iga

et al.

Revista de Gastroenterología de México, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 1, 2025

Citations

0
Review Article: Individualised Management of Reflux‐Like Symptoms—Strategies Beyond Acid Suppression DOI Creative Commons

P. J. Kahrilas,

Laurie Keefer,

Rena Yadlapati

et al.

Alimentary Pharmacology & Therapeutics, Journal Year: 2025, Volume and Issue: unknown

Published: April 1, 2025

ABSTRACT Background Reflux‐like symptoms and reflux oesophagitis are often perceived as having the same acid‐related aetiology responsiveness to antisecretory therapy. However, frequency of residual symptom reporting on proton pump inhibitor (PPI) therapy suggests two entities have some differential pathophysiological determinants requiring distinct management approaches. Aims To examine complexities reflux‐like pathophysiology strategies that may be used target contributing factors beyond acid reflux. Methods A panel ten expert clinicians (primary care, gastroenterology psychology) held a series online meetings share perspectives underlying contributors to, of, when PPIs ineffective or provide partial relief. This review summarises agreed key themes emerged from discussions. Results While degradation anti‐reflux barrier dominates in oesophagitis, cognitive‐affective, behavioural, other psychosocial can play major role persistence. These require individualised strategies, beginning with education gut‐brain connection expectation setting regard PPI detailed clinical history patient‐reported outcome tools measure burden associated anxiety/hypervigilance help guide using brain‐gut behavioural therapies, supported diet/lifestyle modification, diaphragmatic breathing, weight loss, and/or on‐demand control measures according patient's specific needs. Conclusions paradigm shift is required such suppression viewed one several interventions utilised part phenotype‐driven, approach care acknowledges multiple burden.

Language: Английский

Citations

0
Does Stapling Platform Influence Robotic Sleeve Gastrectomy Postoperative Outcomes? DOI Creative Commons
Lee Ying,

Rachael Rutledge,

Samuel D. Butensky

et al.

Obesity Surgery, Journal Year: 2025, Volume and Issue: unknown

Published: April 14, 2025

Abstract Background Laparoscopic sleeve gastrectomy (LSG) accounts for the majority of weight loss surgeries worldwide. Although overall side effect profile is low, rate de novo gastroesophageal reflux disease (GERD) ranges between 2.1 and 49%. Our study compares postoperative outcomes using a single-fire stapler versus multiple-fire linear stapler, with focus on GERD. Methods This was retrospective single-surgeon data from 257 patients who underwent consecutive robotic-assisted 2016 2023 either multiple fires ( n = 201) or 56). Patient demographics outcomes, including 30-day complications, 1-year loss, reflux, were analyzed. Results Patients in group noted to have significantly lower (7.1% vs. 26.4%) decreased incidence (1.8% 10.9%). Additionally, had shorter average length stay (2.0 days 2.2 days, p 0.04). Multivariable analysis demonstrated that use increased likelihood not developing GERD (odds ratio: 8.4, 95% confidence interval: 2.8–32.5). There no significant difference operative time (multiple-fire group: 81.4 min, 90.1 0.5) percent total (multiple-fire: 22.4% ± 0.7%, single-fire: 22.0% 1.7%, 0.8). Conclusions Single-fire may enhance LSG by reducing rates without impacting loss. time, be decreased.

Language: Английский

Citations

0
Proton pump inhibitors – between use and abuse DOI

Mihaela Udrescu

Medic ro, Journal Year: 2024, Volume and Issue: 6(162), P. 38 - 38

Published: Jan. 1, 2024

Language: Английский

Citations

0
Proton Pump Inhibitor Use and Incident Cardiovascular Disease in Older Postmenopausal Women DOI Open Access
Ahmed Soliman, Jean Wactawski‐Wende, Amy E. Millen

et al.

Journal of the American Geriatrics Society, Journal Year: 2024, Volume and Issue: unknown

Published: Dec. 31, 2024

ABSTRACT Background Epidemiological studies have been inconsistent regarding an association between proton pump inhibitor (PPI) use and risk of primary cardiovascular disease (CVD) events. Methods We studied 85,189 postmenopausal women (mean age 63 years at baseline) without known CVD enrollment into the Women's Health Initiative Observational Study (1993–1998). PPI was determined from medication inventories baseline Year‐3. events were physician adjudicated defined as a composite coronary heart disease, stroke, mortality. Follow up to September 2010. Multivariable Cox proportional hazard models used estimate ratios (HR) 95% confidence intervals (CI) for incident according (no/yes), duration (non‐user, < 1 year, 1–3 years, > 3 years), time‐varying based on updated Year‐3 information. Propensity score adjustment control residual confounding. Results At baseline, 1747 (2.1%) reported using PPIs. During mean follow‐up 11 5778 (6.8%) cases identified. users had significantly higher compared with non‐users in fully adjusted model (HR: 1.21, CI: 1.02–1.43), after propensity 1.27, 1.21–1.32). Longer associated incrementally (HRs: year: 1.11, years: 1.33; p trend = 0.02). Conclusions older women. These findings underscore importance guideline‐directed avoid unwanted adverse

Language: Английский

Citations

0