What other health problems have PPI's been alleged to create?

A small percentage of people who take PPI's may not tolerate one drug or another within the PPI family. The most commonly reported side effects, which happen to be rare, are headache, abdominal pain, and diarrhea.  When Prilosec, the first PPI, was brought to market in 1990, there was a theoretical concern that the drug might induce a very rare form of stomach cancer.  That has never turned out to be the case in 21 years of human clinical use.  PPI use was alleged to cause pneumonia.  That idea was based on some very poorly designed research with a major logical flaw and turned out not to be the case.  There was a brief time when PPI's were alleged to cause coronary artery disease; the FDA stepped in and put that notion to rest because the research stating that allegation was really flawed.  The studies alleging these problems were flawed in their design or suffered from the type of design or statistical manipulations described in the hip fracture studies.  More recently, there have been a few articles alleging that PPI use increases the likelihood of a Clostridium difficile infection in the colon, but these studies have not been controlled for the 2 major risk factors for that infection, exposure to the organism in health care facilities and the concurrent use of powerful antibiotics.  The jury is still out on that question.

At the present time, there are some drug interactions that can be related to PPI usage.  PPI's can reduce the intestinal absorption of thyroid hormone medication and should not be taken at the same time of day.  PPI's can reduce the intestinal absorption of medicinal and dietary iron; people taking PPI's who need iron supplementation should consider seeing a hematologist for intravenous iron infusion therapy.  Some PPI's inhibit the liver enzyme which activates the anticoagulant Plavix.  Protonix and Pantoprazole do not do that.   These are the most common considerations which come into play when a person needs to take a PPI along with other medicines.