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chrisrob
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Quote chrisrob Replybullet Topic: PPI side effects
    Posted: 07 Oct 2008 at 2:38pm
I have been reviewing the list of possible side effects from long term usage of Proton Pump Inhibitors (Omeprazole, Lansoprazole, Pantoprazole, Esomeprazole); I am particlularly interested as I seem to suffer from so many of them (not necessarily at the same time - often come in waves of a few weeks only).

Before looking at the list, remember, it is easy to convince yourself you have all sorts of medical conditions when reading a medical dictionary. Also, because you have a headache doesn't mean you have a brain tumour!

Apologies that American spellings are prevalent in the list and there may be some duplication as the list has been stitched from more than one source. I have added some simplified definitions for some of the more obscure terms. If you don't understand a term, google it or look it up in a medical dictionary.

BUT DON'T LET THE LIST ALARM YOU.
I am just interested in what actions drugs have on our bodies.
If you know of any side effects I haven't mentioned, please let me know.

The list follows in a separate box:
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chrisrob
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Quote chrisrob Replybullet Posted: 07 Oct 2008 at 2:46pm
POSSIBLE SIDE EFFECTS OF PROLONGED USAGE OF PPI's

Body as a Whole: abdomen enlarged, allergic reaction, asthenia, back pain, chest pain, chest pain substernal, facial edema, peripheral edema, hot flushes, fatigue, fever, flu-like disorder, generalized edema (water swelling), leg edema, malaise, pain, rigors (shaking);

Cardiovascular: flushing, hypertension, tachycardia;

Endocrine: goiter;

Gastrointestinal: bowel irregularity, constipation aggravated, dyspepsia, dysphagia (difficulty swallowing), dysplasia GI, epigastric pain, eructation (burping), esophageal disorder, frequent stools, gastroenteritis, GI hemorrhage, GI symptoms not otherwise specified, hiccup, melena (tarry stools), mouth disorder, pharynx disorder (sore throat), rectal disorder, serum gastrin increased, tongue disorder, tongue edema, ulcerative stomatitis, vomiting;

Hearing: Otitis media (earache), tinnitus;

Hematologic: anemia, anemia hypochromic, cervical lymphoadenopathy, epistaxis (nose bleed), leukocytosis (raised white blood cell count), leukopenia (reduced white blood cell count), thrombocytopenia (reduced platelet count);

Hepatic: bilirubinemia, hepatic function abnormal, SGOT increased, SGPT increased;

Metabolic/Nutritional: glycosuria (sugar in urine), hyperuricemia (uric acid in blood), hyponatremia (low blood sodium), increased alkaline phosphatase, thirst, vitamin B12 deficiency, weight increase, weight decrease;

Musculoskeletal: arthralgia (painful joints), arthritis aggravated, arthropathy, cramps, fibromyalgia syndrome ,polymyalgia rheumatica (pains and fatigue), hernia;

Nervous System/Psychiatric: anorexia, apathy, appetite increased, confusion, depression aggravated, dizziness, hypertonia, nervousness, hypoesthesia (reduction of sensations), impotence, insomnia, migraine, migraine aggravated, paresthesia (pins & needles), sleep disorder, somnolence, tremor, vertigo, visual field defect;

Reproductive: dysmenorrhea (menstrual pain), menstrual disorder, vaginitis;

Respiratory: asthma aggravated, coughing, dyspnea (uncomfortable breathing), larynx edema, pharyngitis, rhinitis, sinusitis;

Skin and Appendages: acne, angioedema, dermatitis, pruritus (itchiness), pruritus ani, rash, rash erythematous, rash maculo-papular, skin inflammation, sweating increased, urticaria (hives);

Special Senses: otitis media (earache), parosmia (smelling smells that aren't there), taste loss, taste perversion;

Urogenital: abnormal urine, albuminuria, cystitis, dysuria (painful urination), fungal infection, hematuria (blood in urine), micturition frequency, moniliasis (thrush), genital moniliasis, polyuria (excessive volume urination); Visual: conjunctivitis, vision abnormal.

Blood And Lymphatic System Disorders: agranulocytosis (abnormally low white blood cells), pancytopenia (reduction of red and white blood cells);

Eye Disorders: blurred vision;

Gastrointestinal Disorders: pancreatitis; stomatitis (inflammation in the mouth);

Hepatobiliary Disorders: hepatic failure, hepatitis with or without jaundice; Immune System Disorders: anaphylactic reaction/shock; Infections and Infestations:

GI candidiasis (thrush);

Musculoskeletal And Connective Tissue Disorders: muscular weakness, myalgia (muscular pain);

Nervous System Disorders: hepatic encephalopathy, taste disturbance; Psychiatric Disorders: aggression, agitation, depression, hallucination;

Renal and Urinary Disorders: interstitial nephritis;

Reproductive System and Breast Disorders: gynecomastia;

Respiratory, Thoracic and Mediastinal Disorders: bronchospasm (restriction of airway);

Skin and Subcutaneous Tissue Disorders: alopecia, erythema multiforme (red swollen rash), hyperhidrosis (increased perspiration), photosensitivity, Stevens-Johnson syndrome (skin disease), toxic epidermal necrolysis (TEN, some fatal).




Edited by chrisrob - 15 Oct 2008 at 8:57am
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DerekL
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Quote DerekL Replybullet Posted: 10 Oct 2008 at 2:08pm

"Like most drugs there are lots of potential side-effects. You seem to be
one of the unlucky ones but most people thankfully get on pretty well with
these drugs with few if any side-effects" Dr Fitzgerald

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chrisrob
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Quote chrisrob Replybullet Posted: 10 Oct 2008 at 7:05pm

I'd like to thank Dr Fitzpatrick for her input. I certainly don't want to appear alarmist.

I suppose I am kicking myself for not accepting the operation in 1999 but then it would have been a full open Nissen fundoplication rather than the laprascopic procdure. I had been taking omeprazole for a few years then and felt it was keeping things under control. The surgeon, Lt Col Whiteoak, said they didn't like to use PPIs over a long period because they could “mask the observation of a cancer developing.” He didn't mention Barrett's but from what he recorded and what I remember of an examination I had in1994 when the surgeon talked me through what I was watching on the screen as he scoped me, I am sure now, that is what I had. As Robin Thomas says in the article about osteoporosis posted by Derek Larcombe on September 11th, “NICE recommends that patients use PPIs for 2 to 4 weeks”. The drugs companies have carried out long term tests for up to a year. No-one appears to have studied the really long term effects of staying on these “safe” drugs for the length of time some of us are on them for. In that respect, I regard myself as a guinea pig and am interested to report how they appear to be affecting me now after having had no discernible adverse effects for a number of years previously.

When I look at the list above, which I have amassed from internet research carried out in the states, I can identify that in the last few years only, I have been affected by upto 29 of the different listed side effects.

I would have found this useful in 1999 and may have persuaded me then to have had the operation. I have an appointment at the surgeon's clinic in November when I hope to be added to the waiting list, twenty months after my GP agreeing to send me to the specialists again, and with any luck, I may get the operation 10 years after I was first recommended for it.



Edited by chrisrob - 10 Oct 2008 at 7:06pm
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chrisrob
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Quote chrisrob Replybullet Posted: 15 Nov 2008 at 8:50am
On further reading, I realise I missed out the most fundamental. If someone is on the highest level of PPIs twice a day, they may produce nearly zero amount of gastric acid. This is known as hypochlorhydria responsible for many of the symptoms described above. This article explains the condition further: http://www.drmyhill.co.uk/article.cfm?id=404
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