How Proton Pump Inhibitors Work

If you suffer from gastroesophageal reflux disease (GERD), heartburn, or gastric ulcers, your doctor may prescribe a class of drugs called proton pump inhibitors (PPIs) to ease your symptoms.

PPIs block an enzyme in the stomach wall that produces acid. When the enzyme is blocked, acid production decreases, allowing any ulcers that exist in the esophagus, stomach, and duodenum (the first part of the small intestine) to heal.

Are You a Good Candidate for PPIs?

While occasional bouts of heartburn are not worrisome, if you experience the problem at least twice a week and antacids or H2 (histamine) blockers do not relieve your symptoms or if you have frequent episodes of GERD (regurgitation of food into your throat or mouth), your doctor may recommend that you take a PPI.

Proton pump inhibitors include lansoprazole (Dexilant®, Prevacid®), omeprazole (Prilosec®, Zegerid®), pantoprazole (Protonix®), rabeprazole (AcipHex®), and esomeprazole (Nexium®), which are available by prescription. Prilosec® and Zegerid® are also available in over-the-counter strength.

Proton pump inhibitors are more effective than H2 blockers. PPIs can relieve heartburn-related symptoms and heal the esophageal lining in almost everyone who has GERD. While all PPIs are similar in action and there is no evidence that one drug is more effective than another, they do differ in how they are broken down by the liver, making the effects of some PPIs last longer than others. Although PPIs interact with few drugs, in some incidences they can reduce the effectiveness of certain medications or increase the toxicity of others. For example, Prilosec® (omeprazole) can potentially increase the concentration in the blood if taken with medications such as the anti-anxiety drug Valium® (diazepam), the blood thinner Coumadin® (warfarin), and the anti-seizure drug Dilantin® (phenytoin), resulting in extreme side effects. Talk with your doctor about which PPI would be most effective and safe for you.

While PPIs are generally well tolerated, some common side effects include headache, diarrhea, constipation, stomach pain, nausea, and rash.

To reduce heartburn and GERD symptoms, try these tips:

  • Limit the amount of acidic foods you eat, including grapefruit, oranges, and tomatoes.
  • Cut back on spicy and fatty foods.
  • Avoid drinks that can trigger acid reflux such as alcohol, caffeinated, and carbonated beverages.
  • Eat four or five smaller meals a day instead of three bigger ones.




National Digestive Diseases Information Clearinghouse (NDDIC)
Heartburn, Gastroesophageal Reflux (GER), and Gastroesophageal Reflux Disease (GERD)

Proton Pump Inhibitors (PPIs)