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Review
. 2022 Dec;10(12):3117-3123.
doi: 10.1016/j.jaip.2022.09.022. Epub 2022 Sep 23.

Proton Pump Inhibitors in Allergy: Benefits and Risks

Lacey B Robinson  1 , Melanie A Ruffner  2
Affiliations
Review

Proton Pump Inhibitors in Allergy: Benefits and Risks

Lacey B Robinson et al. J Allergy Clin Immunol Pract. 2022 Dec.

Abstract

Proton pump inhibitors (PPIs) are widely prescribed and are indicated for the treatment of several gastrointestinal disorders. Allergists may prescribe PPIs as a result of the coincidence of gastroesophageal reflux disease with asthma or rhinitis, or when gastroesophageal reflux disease presents as chronic cough. Furthermore, long-term, high-dose PPI therapy is a recommended option for managing eosinophilic esophagitis, resulting in histologic remission in approximately 40% of patients. Here, we discuss current recommendations for PPI use, its deescalation, and its side effect profile. We review evidence supporting the epidemiologic link between the use of acid-suppressant medication and the subsequent development of allergic disorders.

Keywords: Adverse events; Asthma; Eosinophilic esophagitis; Hypersensitivity; Proton pump inhibitor.

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Figures

Figure 1:
Figure 1:
Schematic of hypothesis of mechanistic link between early life PPI exposure and risk of subsequent atopy. In susceptible individuals, prenatal or early life PPI exposure reduces gastric acid. While this mechanism is not fully understood, microbial dysbiosis and later atopic disease may occur in a subset of patients. Figure created with biorender.com.
See this image and copyright information in PMC

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