Will a PPI Work for You?
One of the ways that acid reflux is treated is with a group of drugs called proton pump inhibitors (PPIs). These medicines work by slowing down your ability to produce stomach acid. While PPIs have worked wonders for some, for others they have not been very effective.
How do you know if a PPI will work for you? Here is what we know for sure.
The efficacy of PPIs is complicated for several reasons. One reason is that there are many different "types" of acid reflux. For example, there is relatively little research available about whether or not PPIs work in patients with "non-erosive" reflux disease. What research is available for this type of reflux supports the idea that PPIs seem to help patients feel better, but for this type of heartburn, these medicines are less likely to completely control the heartburn (Dean, 2004).
When researchers looked at whether PPIs work on chronic laryngitis (a condition possibly linked to acid reflux disease), they found that about half of the patients saw relief but half of the patients did not respond to the drug (The American Journal of Gastroenterology).
We do know that PPIs can be effective for healing erosive esosphagitis and controlling overall acid reflux disease symptoms over 90 percent of the time. In one study, after six months on the medication, more than 70 percent of the patients remained symptom-free. The interesting part is that in some of the studies, it took up to four to know whether or not the PPI worked (a virtual lifetime if one is suffering daily).
One of the questions to be answered next by researchers will be: What are the predictors of clinical response? In other words, is there a way to know ahead of time who the drugs will work on and who they will not work on? This research is already underway and it was recently discovered (Wang, 2013) that how high the reflux travels within the esophagus matters to the effectiveness of the PPI as well as whether or not other digestive disorders are present such as irritable bowel syndrome. To complicate matters even more, scientists are discovering that whether or not the PPI works may depend on if the patients suffer from depression or not.
The bottom line: When it comes to whether or not a PPI will work for you, a lot of factors are at play. The answer is anything but simple and straightforward. The best advice is to make sure your physician is up to date on the research and has an understanding of the lack of predictability of these drugs. As a patient, you need to know that while these drugs can make a huge difference for some, they do not work for all. You also need to understand that it might take at least a month or more to know if the PPI will be helpful in relieving your symptoms.