Harvard Health Letter

What you should know about: PPIs

If you suffer from chronic heartburn or another digestive disorder, you may have been prescribed a proton-pump inhibitor (PPI), which helps reduce the production of stomach acid. There are several different types of PPIs. Prescription-only PPIs include esomeprazole (Nexium) and pantoprazole (Protonix). Some PPIs are also available over the counter, including lansoprazole (Prevacid) and omeprazole (Prilosec).

How they work

PPIs work by inhibiting certain stomach cells from "pumping" acid into the stomach. When taken 30 to 60 minutes before a meal, PPIs can prevent or reduce heartburn. However, they do not work as well when taken on demand as they do when taken over a period of time. And while PPIs are generally safe when used in the short term, they do carry some risks in the long term. Unfortunately, the medications tend to be overused. "I think a lot of people get heartburn from taking medications or ingesting certain food and drinks. To treat their symptoms they get PPIs over the counter or from their physicians," says Dr. Jacqueline Wolf, associate professor of medicine at Harvard Medical School.

Acid Reflux (heartburn)

Acid Reflux (heartburn)

To reduce heartburn risk:

  • Avoid eating within two to three hours of bedtime.

  • Eat smaller meals.

  • Stop smoking.

  • Decrease caffeine.

  • Raise the head of your bed.

  • Avoid mint, carbonated drinks, sparkling water, alcohol, onions, garlic, citrus, and tomato.

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