In addition to increased risk of osteoporotic fractures, Clostridium difficile, and other infections,1 proton pump inhibitors (PPIs) may have also contributed to the sharp rise in gastroesophageal malignant diseases seen over the past 2 decades. This is especially true for esophageal adenocarcinoma, which was previously uncommon, and mirrors the increased use of these drugs.2,3 It has been suggested that with PPIs, pancreatic enzymes that would have previously been inactivated by hydrochloric acid are able to irritate and cause dysplasia in esophageal tissue in patients with reflux disease. There is also evidence that gastroesophageal reflux disease (GERD) may not develop from direct superficial injury but rather from stimulation of esophageal cytokines that attract inflammatory cells to submucosal tissues.4
Rosch PJ. Could Proton Pump Inhibitors Cause Cancer? Arch Intern Med. 2010;170(19):1775–1776. doi:10.1001/archinternmed.2010.375
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