Proton Pump Inhibitor Effects on Gastric Mucosal Health
Summary
Proton pump inhibitors (PPIs) are among the most widely prescribed agents for the suppression of gastric acid secretion and the management of acid-related disorders. By irreversibly inhibiting the H+,K+-ATPase proton pump of parietal cells, PPIs raise intragastric pH and promote healing of peptic lesions. However, prolonged acid suppression induces compensatory changes in the gastric mucosa, including hypergastrinemia, parietal cell hyperplasia and alterations in epithelial turnover. These changes manifest clinically as fundic gland polyps, mucosal inflammation, and, in some populations, increased susceptibility to enteric infection and nutrient malabsorption. Endoscopic patterns such as “black spots” and “white globe appearance” have emerged as visual markers of PPI-related mucosal adaptation. The global prevalence of long-term PPI use underscores a pressing need to balance therapeutic benefit against potential mucosal alterations and to refine prescribing practices according to evidence-based indications.
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Proton Pump Inhibitor Effects on Gastric Mucosal Health publication trend
The graph below shows the total number of articles in proton pump inhibitor effects on gastric mucosal health across all publications each year (not limited to Nature Index journals).
Technical terms
Proton pump inhibitor (PPI): A class of medications that suppress gastric acid secretion by irreversibly blocking the H+,K+-ATPase enzyme in parietal cells.
Gastric mucosa: The innermost layer of the stomach wall, composed of specialised epithelial cells and glands that secrete acid, enzymes and mucus.
Fundic gland polyp: A benign epithelial lesion arising in the gastric fundus and body, often associated with chronic acid suppression and parietal cell changes.
Hypergastrinemia: An elevated concentration of gastrin hormone in the blood, typically resulting from sustained acid suppression and leading to trophic effects on the gastric mucosa.
References
- Gastric Polyps in Long-Term Proton Pump Inhibitor Use: Identification of Risks and Characteristics. Cureus (2024).
- Iron deposition in gastric black spots: Clinicopathological insights and NanoSuit‐correlative light and electron microscopy analysis. DEN Open (2024).
- White Spot, a Novel Endoscopic Finding, May Be Associated with Acid-Suppressing Agents and Hypergastrinemia. Journal of Clinical Medicine (2021).
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