PPI use prompts digestion concerns

A veteran pharmacist warns that long term omeprazole use could affect digestion, amid rising NHS prescriptions.

PPI use prompts digestion concerns and NHS budget debate

Deborah Grayson, a veteran pharmacist known as the Godmother of Pharmacology, used TikTok to warn that omeprazole, a proton pump inhibitor, may harm digestion over the long term even as it relieves heartburn for many. The video has attracted more than 42 thousand views and notes that PPIs are among the UKs most prescribed medicines, with 73 million NHS prescriptions dispensed in England in 2022-23 at a cost of about 190 million pounds. Grayson explains that PPIs work by reducing stomach acid, which can ease reflux but may disrupt digestion if acid production stays low for extended periods.

She says omeprazole is appropriate for gastritis or erosions, but for simple heartburn long term use could have wider effects. Stomach acid helps digest proteins, activate enzymes like pepsin, and defend the gut from microbes. She warns that low acid may cause bloating, nutrient gaps such as vitamin B12, iron, calcium and magnesium, and raise infection risks including Clostridium difficile. Grayson also promotes lifestyle changes and an exit plan from PPI treatment, arguing that over prescribing without clear guidance risks turning PPI use into a habit.

This story spotlights a common tension in medicine: provide quick relief now while watching for longer term costs. A social media post from a long-time pharmacist brings clinical nuance into public view, but bite sized formats can oversimplify. It underlines the need for clear patient guidance on when to start and stop PPIs and how to reintroduce normal stomach acid gradually.

From a policy angle, the piece raises questions about prescribing guidelines, patient education, and the financial burden of chronic PPI use. The NHS faces persistent demand for acid related care and must balance access with stewardship. The takeaway is a call for stronger exits from treatment and better conversations between clinicians and patients to avoid a culture of dependency.

Highlights

The health system needs a careful balance between relief and long term gut health