Acid Reflux

Proton Pump Inhibitors, Explained

For people who experience frequent heartburn that noticeably disrupts your life, proton pump inhibitor medications (or PPIs) may be helpful.¹ In this article, we go through some frequently asked questions about PPIs and how they work to relieve frequent heartburn.

What is a proton pump inhibitor?

A PPI is a type of medication that can be used to relieve the symptoms of gastro-oesophageal reflux.¹ Common symptoms of reflux include heartburn (a burning sensation felt behind the breastbone) as well as regurgitation, which is when your stomach contents flow back up into throat or mouth.¹

For mild symptoms that only occur occasionally, changes to diet and lifestyle are usually enough to get relief.¹ For more troublesome symptoms however, medication may be needed in addition to diet and lifestyle changes.¹ PPIs are considered an effective medication for relieving symptoms of reflux.^1-3

Is Gaviscon a PPI?

No, Gaviscon is not a PPI – it’s an alginate-based therapy.

How do proton pump inhibitors work?

A proton pump is a type of enzyme found in the lining of the stomach, which is responsible for secreting gastric acid.^1,5 Gastric acid causes the discomfort of heartburn when it is refluxed into the oesophagus.²

A proton pump inhibitor – as the name suggests – relieves acid reflux by binding to and blocking these proton pumps, essentially stopping them from producing as much gastric acid.^1,3,5 The stomach therefore becomes less acidic, which helps reduce the symptoms of heartburn and also allows your oesophagus to heal from any inflammation.^1,3

Once a PPI acts on a proton pump, the binding is irreversible and acid secretion will only be restored when new proton pumps are created by the body.^1,3 This means that the beneficial effects of PPIs are usually long-lasting.^1,3

What is the correct proton pump inhibitor dosage?

PPIs are usually taken once a day however your doctor may recommend a different dosing regimen based on your specific needs.^1-3

It’s also recommended to take it consistently at about the same time each day, whenever your symptoms are worse.¹ Keeping a regular time for taking your PPI may help you remember to take it.

Be aware that PPIs may take a few days to act on all proton pumps and reach their full effect.^1,3 Over-the-counter PPIs should also not be taken for more than 2 weeks, unless otherwise advised by your doctor.^1.3

PPI side effects

In general, people tolerate PPIs well. However, some people may experience side effects such as headache, nausea, vomiting, stomach pain, constipation and/or wind. You should tell your doctor or pharmacist if you notice these symptoms and they worry you.⁶

It's important to tell your pharmacist or doctor if you have any medical conditions before starting a PPI as they may not be suitable for you.⁶

Antacids vs PPIs

Are you wondering what’s the difference between antacids and PPIs? While PPIs stop gastric acid from being made and released, an antacid simply neutralises the acid that has already been released into the stomach.¹ Both work to make the stomach contents less acidic, but the main difference is that the PPI acts on gastric acid at the source of its production.

H2 blockers are another treatment for reflux that work by reducing the amount of acid your stomach makes.⁶

Always read the label. Use only as directed. If symptoms persist, see your healthcare professional. Reckitt Benckiser, Auckland. TAPS NP19476. RB-M-100859.

References:

MacFarlane B. Management of gastroesophageal reflux disease in adults: a pharmacist’s perspective. Integr Pharm Res Pract. 2018;7:41-52.
Galmiche JP, et al. Treatment of GORD: three decades of progress and disappointments. United European Gastroenterol J. 2013;1(3):140-50.
Strand DS, et al. 25 years of proton pump inhibitors: a comprehensive review. Gut Liver. 2017;11(1):27-37.
Peura DA, et al. Esomeprazole treatment of frequent heartburn: two randomized, double-blind, placebo-controlled trials. Postgrad Med. 2014;126(4):33-41.
Gracie DJ, Ford AC. The possible risks of proton pump inhibitors. Med J Aust. 2016;205(7):292-293.
Australian Medicines Handbook. Drugs for dyspepsia, reflux and peptic ulcers. Available at: https://amhonline.amh.net.au/ (accessed July 2020).

First published: 7th May 2021

Last updated: 22nd January 2024

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