What is a PPI?


What is a PPI?

A Proton Pump Inhibitor (PPI) is a medication that is most commonly prescribed to manage a variety of gastrointestinal disorders. It is also the most commonly prescribed medication worldwide.

This medication was introduced in the 1990’s and its use has increased more than 1000% in Australia with over 19 million prescriptions written in 2013-2014. It is used to help with gastric reflux or heartburn, Barrett oesophagus and a prophylaxis for bleeding associated with nonsteroidal anti-inflammatory drugs (NSAIDS).

Some of these medications include the following:

  • omeprazole (Prilosec, Prilosec OTC, Zegerid)
  • lansoprazole (Prevacid)
  • pantoprazole (Protonix)
  • rabeprazole (Aciphex)
  • esomeprazole (Nexium)
  • dexlansoprazole (Dexilant)

Nexium and Prilosec are the most commonly prescribed PPI’s.

The long term use of these PPI’s impacts on the health of your gut. PPI’s lower the microbial diversity and level of commensals which can lead to chronic gut disorders. Small intestinal overgrowth or otherwise known as SIBO can happen due to the changes in the microbiota and the change in digestive motility. Long term users may also experience leaky gut and IBS symptoms.

Long term PPI use has also been found to impair endothelial function which can lead to vascular damage. This is likely the mechanism that links a higher cardiovascular, renal and dementia risk for people taking these medications long term.

Reflux or acid imbalance can be treated with diet, lifestyle and herbal support, so before looking at these types of medications perhaps you should consider the alternatives. Book in for a consult to find the cause of this acid reflux.


Yepuri, G., Sukhovershin, R., Nazari-Shafti, T. Z., Petrascheck, M., Ghebre, Y. T., & Cooke, J. P. (2016). Proton Pump Inhibitors Accelerate Endothelial Senescence. Circulation Research, 118(12), e36–e42. https://doi.org/10.1161/CIRCRESAHA.116.308807

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