Proton Pump Inhibitors

Articles tagged with "Proton Pump Inhibitors".

PPIs Increase Fracture Risk by 30%: Meta-Analysis of 11 Studies

Tags: PPI Fracture Risk, Proton Pump Inhibitors, Bone Health, Osteoporosis

November 7, 2025

Do Proton Pump Inhibitors Increase Your Risk of Bone Fractures?

Yes, proton pump inhibitors significantly increase fracture risk by approximately 30% overall, with hip fractures showing a 34% increased risk according to this comprehensive meta-analysis of 11 international studies. The risk appears highest with long-term use and higher doses, particularly affecting hip, spine, and wrist fractures in older adults.

Dr. Kumar’s Take

This meta-analysis provides compelling evidence for one of the most serious long-term PPI risks. A 30% increased fracture risk is clinically significant, especially for older adults who are already at higher baseline fracture risk. The mechanism likely involves impaired calcium absorption due to reduced stomach acid, along with potential direct effects on bone metabolism. This doesn’t mean we should avoid PPIs when truly needed, but it reinforces the importance of using the lowest effective dose for the shortest duration possible, especially in high-risk patients.

PPIs Increase Small Intestinal Bacterial Overgrowth Risk by 71%

Tags: PPI SIBO Risk, Small Intestinal Bacterial Overgrowth, Proton Pump Inhibitors, Gut Microbiome

November 7, 2025

Do Proton Pump Inhibitors Increase Risk of Small Intestinal Bacterial Overgrowth?

Yes, proton pump inhibitors moderately but significantly increase the risk of small intestinal bacterial overgrowth (SIBO) by approximately 71% according to this comprehensive meta-analysis. The increased risk appears related to PPI-induced changes in gastric acid levels that normally help prevent bacterial overgrowth in the small intestine.

Dr. Kumar’s Take

This meta-analysis adds another important consideration to the PPI risk-benefit equation. A 71% increased SIBO risk is clinically meaningful, especially since SIBO can cause symptoms that overlap with the original GERD symptoms - bloating, abdominal pain, and digestive issues. This creates a potential cycle where PPIs treat one problem but create another that might require additional treatment. It reinforces the importance of using PPIs judiciously and for appropriate durations.