"The doctor prescribed omeprazole, my stomachache can't do without this medicine." Patients often say this in the outpatient setting. Omeprazole has become a well-known stomach medicine "brother", but is it really a panacea? Can it really be used for a long time?
Gastric juice can be a "double-edged sword". Its main component is stomach acid, which plays an important role in digesting food. Stomach acid can not only kill bacteria in food, but also decompose connective tissues and muscle fibers in food, denatured proteins in food, and easy to be digested; However, excessive gastric acid secretion will have an erosive effect on the gastric mucosa, causing inflammation or ulceration of the stomach.
Omeprazole is a proton pump inhibitor that effectively inhibits gastric acid, increases gastric pH, and has therapeutic effects on the following diseases:
Peptic ulcer omeprazole can effectively inhibit stomach acid, promote the healing of peptic ulcer, and reduce complications and relieve symptoms.
Gastroesophageal reflux Patients with gastroesophageal reflux will have acid reflux, heartburn and other symptoms, and the use of omeprazole for acid suppression therapy can effectively control symptoms and promote the healing of esophagitis.
Upper gastrointestinal bleeding omeprazole can effectively increase gastric pH and reduce the relysis of blood clots in the stomach, thereby effectively treating upper gastrointestinal bleeding.
However, if omeprazole is regarded as a "universal stomach medicine", long-term use will bring serious side effects.
Gastrointestinal reactions When omeprazole reduces gastric acid secretion, it can cause symptoms such as epigastric fullness, abdominal pain, diarrhea, constipation, nausea, vomiting, dry mouth, etc.
Poor absorption of vitamin B12 Stomach acid converts the dietary vitamin B12-protein-binding state into vitamin B12, which is eventually absorbed by the terminal ileum. Long-term use of omeprazole can lead to impaired absorption of vitamin B12.
Long-term use of proton pump inhibitors, including omeprazole, increases the risk of gastric polyps, gastric cancer, gastric carcinoids, and colorectal cancer.
Intestinal infection Long-term use of proton pump inhibitors can alkalize the gastric environment, reduce the function of the gastric acid barrier, lead to bacterial colonization in the stomach and overgrowth of intestinal flora, and increase the risk of intestinal infection caused by Clostridium difficile and other pathogens.
Easier fractures Omeprazole causes alkalinization of the gastric environment, which can affect calcium absorption and inhibit osteoclast-mediated bone resorption, making fractures more likely.
Therefore, it is important not to use proton pump inhibitors, including omeprazole, and to treat them symptomatically under the guidance of doctors and pharmacists.
Text/Guo Wenjun (Beijing Tsinghua Chang Gung Hospital) (Source: Beijing Youth Daily)