[Newly recognized side-effects of proton pump inhibitors. Arguments in favour of fundoplication for GERD?].

摘要: Among other indications proton pump inhibitors (PPIs) are used as medical treatment of gastroesophageal reflux disease (GERD) and the most frequently prescribed drugs in gastroenterology. Until recently PPIs were regarded very safe associated with few side-effects. However, during recent years study results have revealed many severe adverse events especially long-term PPI use. We review currently available evidence, regarding side-effects discuss potential impact on strategies for GERD (conservative vs. antireflux surgery). Currently data suggest that osteoporosis-related fractures, Clostridium difficile diarrhea (CDAD), community hospital-acquired pneumonia, pharmacologic interaction clopidogrel acetylsalicylic acid subsequent increased rate cardiovascular events, refractory hypomagnesemia rebound symptoms etc. The risk-benefit ratio is increasingly recognized being less favourable. This leads to a more critical viewpoint raises question whether may outweigh benefits, seem make strong argument favour laparoscopic fundoplication GERD.