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Taking proton pump inhibitors (PPIs) to ease the symptoms of excess stomach acid for more than two years was linked to a 65 percent increase in the risk of vitamin B-12 deficiency.

Only slight to moderate increases in pantoprazole AUC (43%) and C max (26%) were found in elderly volunteers (64 to 76 years of age) after repeated oral administration, compared with younger subjects.

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The exact pathologic process by which this occurs is complex and yet to be fully characterized, but there are two requirements for heartburn, regardless of a diagnosis of erosive or nonerosive disease: these are high concentrations of acid within the esophageal lumen (reflux) and a damaged esophageal epithelium.

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The aim of the current review is to summarize current evidence on clinical and cost-effectiveness of proton pump inhibitors (PPIs) for the treatment of gastrointestinal diseases, which may be used to update knowledge mobilization tools developed based on earlier evidence.

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However, given that recent research shows PPIs may be habit-forming, that the majority of PPI use is probably inappropriate, with minimal or no benefit to the patient, and that new, life-threatening risks with long-term therapy are continually emerging, it is time for the medical community to re-evaluate the role of PPIs in everyday practice.

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Because of these rebound symptoms, there may be a need for further and continuous PPI use.

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Medical therapy for chronic reflux esophagitis.

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Appropriate studies have not been performed on the relationship of age to the effects of pantoprazole to treat erosive esophagitis in children younger than 5 years of age.

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For those patients who have not healed after 8 weeks of treatment, an additional 8-week course of ACIPHEX may be considered.

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Due to the chronic nature of GERD, there may be a potential for prolonged administration of Pantoprazole.

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While the IR formulation seemed to be superior, several patient still demonstrated overnight acid recovery, highlighting the need for a once-daily PPI formulation that provides better night time acid control.

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Influence of omeprazole on the antiplatelet action of clopidogrel associated with aspirin.

Esomeprazole has been reported to have a somewhat higher potency in acid inhibition than other PPIs.

Although the healing rate in subjects administered esomeprazole tended to be higher than in those administered omeprazole, lansoprazole and pantoprazole, the differences did not reach statistically significant levels.

One out of three of these studies was supported by the manufacturer of esomeprazole, showing some benefits of esomeprazole for patients with more severe esophagitis ().

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