In this podcast, Drs. Ebell and Wilkes discuss the use of PPIs. The study they review looked at one million users of PPI medicines from 1990 to 2018.1
The comparison group was patients on H2 blockers to control for confounders. After controlling for confounders there was an association with gastric cancer. The numbers needed to harm were 2000 users after 5 years and 1200 users over 10 years to get gastric cancer. The risk was higher in patients on higher doses.
Their advice was to try short periods and lower doses of PPI. They acknowledge that patients are not keen to stop PPI as they give so much comfort. Ranitidine is no longer available in NZ but famotidine is available and fully funded.