Why is long-term use of proton pump inhibitors (PPIs) discouraged?

Long-term use of proton pump inhibitors (PPIs) is discouraged primarily due to several associated risks, among which the increased risk of hip fractures is a notable concern. Studies have shown that individuals on long-term PPI therapy may experience decreased calcium absorption, which can lead to osteoporotic changes and ultimately increase the risk of fractures, particularly in the hip region. This effect is particularly relevant in older adults, who are already more susceptible to fractures due to age-related bone density loss.

While other risks such as gastrointestinal infections, kidney damage, and hypersensitivity reactions are also important considerations when evaluating the safety of long-term PPI use, the association with hip fractures is particularly significant in geriatric populations. The risk of fractures can have serious implications for mobility and overall health, making it a critical factor in clinical decisions regarding PPI therapy. Health care professionals must weigh these risks against the benefits of PPI use, as inappropriate long-term usage can lead to complications that detract from patient health and quality of life.