I am 38 with acid reflux. Any long-term risks of PPI use?

Question

Hello doctor,

I am a 38-year-old man suffering from chronic heartburn and acid reflux, especially after meals and when lying down. My endoscopy last year showed mild esophagitis. I have been on Omeprazole daily for six months, but symptoms return if I stop it. Please tell me,

Are there risks with long-term PPI use, like vitamin deficiencies or kidney problems?
Would lifestyle changes or weight loss alone help me stop medication?
When is fundoplication recommended, and how successful is it?

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

I understand how frustrating it can be to deal with chronic heartburn and reflux, especially when medications like Omeprazole help only while you are taking them. Long-term use of proton pump inhibitors (PPIs) can be very effective, but they are associated with some potential risks, including reduced absorption of vitamin B12, magnesium, and calcium, which can lead to deficiencies over time. Rarely, prolonged use has also been linked to kidney issues and an increased risk of certain infections. Regular monitoring with your doctor can help minimize these risks.

Lifestyle changes can make a significant difference in controlling reflux and may reduce dependence on medication.

Losing weight if overweight.
Avoiding large or late meals.
Limiting alcohol, caffeine, and spicy or fatty foods.
Elevating the head of your bed and not lying down immediately after eating are all helpful strategies.

Surgery, such as fundoplication, is usually considered when symptoms are severe, persistent despite optimal medical therapy, or when complications like esophagitis or strictures develop. The procedure reinforces the valve between the stomach and esophagus, reducing reflux, and has a high success rate in appropriately selected patients. However, it carries surgical risks, and some patients may still need occasional medications afterwards.

I hope this information helps you.

Feel free to ask further queries.

Thank you.