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Journal für Gastroenterologische und Hepatologische Erkrankungen

Erschienen in:

29.05.2019 | Originalien

Gastroösophageale Refluxkrankheit

Langzeitnebenwirkungen von Protonenpumpenhemmern

verfasst von: Prof. Dr. med. Thomas Frieling

Erschienen in: Journal für Gastroenterologische und Hepatologische Erkrankungen | Ausgabe 2/2019

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Zusammenfassung

Protonenpumpenhemmer (PPI) werden weltweit aufgrund von Fehlindikationen zu häufig und in zu hohen Dosen verschrieben. Hierbei können PPI selbst die Symptome erzeugen, die sie eigentlich behandeln sollen. Leitliniengerechte Indikationen für den Langzeiteinsatz von PPI sind die gesicherte gastroösophageale Refluxkrankheit (GERD), die Therapie mit traditionellen nichtsteroidalen Antirheumatika (tNSAR) mit Risiko für bzw. mit manifesten gastrointestinalen Blutungen, tNSAR mit Acetylsalicylsäure (ASS)/Plättchenhemmern/direkte orale Antikoagulanzien (DOAK)/ Vitamin K Antagonisten (VKA), Therapie mit ASS/Plättchenhemmern/DOAK/VKA und Risikofaktoren bzw. Blutungen, Therapie mit ASS/COX-2-Hemmer und Anamnese mit gastrointestinaler Blutung bzw. Risikofaktoren, simultane Therapie mit 2 gerinnungsaktiven Substanzen (z. B. ASS und Clopidrogel) bzw. idiopathische Blutungen mit Ulzera.

Die potenziellen Langzeitnebenwirkungen von PPI (Demenz, M. Alzheimer, Osteoporose, Interaktion mit Clopidrogel, Infektionen, Malabsorption, Allergien) werden kontrovers diskutiert. Hierbei existieren zurzeit Metaanalysen, die ein moderates Risikopotenzial aufzeigen, während andere Metaanalysen keine Gefährdung hinsichtlich der Langzeiteinnahme von PPI sehen. Diese Datenlage muss den Patienten auch so vermittelt werden, da die PPI bei korrekter Indikation auch in der Langzeittherapie wertvolle Medikamente sind und unnötige Ängste vermieden werden sollten.

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Titel: Gastroösophageale Refluxkrankheit
Langzeitnebenwirkungen von Protonenpumpenhemmern
verfasst von: Prof. Dr. med. Thomas Frieling
Publikationsdatum: 29.05.2019
Verlag: Springer Vienna
Erschienen in: Journal für Gastroenterologische und Hepatologische Erkrankungen / Ausgabe 2/2019
Print ISSN: 1728-6263
Elektronische ISSN: 1728-6271
DOI: https://doi.org/10.1007/s41971-019-0047-0

Springer Medizin Österreich

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