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A doctor has issued a warning to anyone taking proton pump inhibitors (PPIs) like omeprazole. BBC Morning Live's Dr Punam Krishan said people taking the medication - typically for issues like heartburn, acid reflux, and indigestion - need to be careful, particularly if they are taking it for a long time. Dr Punam, a practising NHS GP and resident doctor on the BBC show, stressed the importance of having regular check-ups if you are taking PPIs, The Mirror reports . The NHS GP told hosts Gethin Jones and Helen Skelton: "Essentially these medications aren't there to be used unnecessarily or for a long period of time. They do require us to review them. And that's because if used over a long period of time, they can slightly increase your risk of things like low magnesium, low vitamin B12, but also increase the risk of gut infections, particularly Clostridioides difficile. We call that C. diff for short." Dr Punam continued: "Now, we have this bacteria in our bowel, you and I, we all have it, and it lives in balance. However, medications like PPIs can tip that balance. And if you get overgrowth of this bacterium, it can cause persistent diarrhoea. That is a red flag. "So you do need to speak to your doctor if that is an issue and you suddenly start developing diarrhoea. Or if you've got a change in bowel habit, we always say check in with your doctor. Just make sure that you are getting those reviews with your GP." The warning comes just weeks after the NHS reminded Brits of the long-term risks of the drug. The NHS said on its website: "Do not take omeprazole for longer than two weeks if you bought it without a prescription. See a GP if your symptoms get worse or do not get better." In the UK, one in four adults is affected by acid reflux, and many people will experience it at some point in their lives, especially after large meals. People who suffer from it consistently may be prescribed PPIs like omeprazole to help deal with symptoms. Common PPIs include Omeprazole (Prilosec), Esomeprazole (Nexium), Lansoprazole (Prevacid), Pantoprazole (Protonix), and Rabeprazole (AcipHex). The latest figures reveal that in England, 73 million NHS prescriptions for all PPIs were issued throughout 2022-23, with omeprazole ranking as one of the two most commonly prescribed medications. Dr Punam said: "Acid reflux is all about what happens in your stomach. So we all have acid in our stomach and it has a very important role. The role of that is to break down and digest the food. Now, at the top of the stomach, we have a little valve, a sphincter, and it acts like a trapdoor. "And its job is to basically seal the contents so the acid is not essentially tracking back up the food pipe, your oesophagus. However, if that sphincter, that valve, becomes too loose, it can become very relaxed by things like heavy meals. If you've had alcohol, if you lie down straight after having a heavy meal, that can actually mean that that acid from the stomach can end up creeping back up the food pipe and cause that heavy pressured burning sensation that people get." If you are taking omeprazole without a prescription, do not take it for longer than two weeks. You should see a doctor if: If your doctor has prescribed omeprazole for extended use, they should monitor you regularly. If your doctor recommends omeprazole for over a year, it's essential to have regular check-ups to reduce the chances of experiencing long-term side effects. Signs of low magnesium include muscle cramps, fatigue, and an irregular heartbeat, along with less specific symptoms like loss of appetite, nausea, and weakness. More severe deficiencies can lead to numbness, tingling, personality changes, seizures, and abnormal heart rhythms. Signs of low vitamin B12 include fatigue, weakness, pale skin, and a sore or swollen red tongue. Other symptoms can include neurological issues like pins and needles, difficulty with balance, and memory problems, as well as shortness of breath, heart palpitations, and digestive problems. Symptoms of a C. diff gut infection are watery diarrhoea, stomach cramps and pain, a high temperature (fever), nausea, loss of appetite, and dehydration. In severe cases, complications can arise, such as life-threatening inflammation of the intestines.
