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• Commonly used medications for GERD may affect the colonic mucosa
• H2 antagonists (H2RAs) ranitidine, cimetidine famotidine reduce acid secretion by 60 to 70%.
• Proton pump inhibitors (PPIs) omeprazole, pantoprazole, lansoprazole, esomeprazole and rabeprazole reduce acid secretion by inhibiting the H+ (proton) secreting pump, reducing hydrochloric acid by 80 to 95%.
• Diarrhea is one of the most commonly reported adverse events.
• H2RAs and PPIs have the physiological and functional potential to interfere with gastrointestinal physiology by altering intestinal pH.
• Microcytic colitis causing chronic diarrhea and colonic inflammation is a significant complication risk after the > 4-8 week use of H2RAs and PPIs.
• The overall incidence of microcytic colitis has increased in both Europe and North America concurrent to the use of PPIs and H2RAs.
• Drugs associated with microscopic colitis are the H2 antagonist ranitidine (Zantac) and proton pump inhibitors lansoprazole (Prevacid), omeprazole (Prilosec) and esomeprazole (Nexium).
Physician Assistant Studies
Master of Physician Assistant Studies (MPAS)
Colitis, Microscopic -- chemically induced; Histamine H2 Antagonists -- adverse effects; Proton Pump Inhibitors -- adverse effects
Kremer, Reiner, "Comparing the Long Term Use of H2 Antagonists (H2RAs) and Proton Pump Inhibitors (PPIs) and the Incidence of Colitis" (2014). Physician Assistant Scholarly Project Posters. 124.