Proton pump inhibitors (PPI) medication reduces the amount of acid your stomach makes and is a widely-used treatment for indigestion, reflux and stomach ulcers.

Different types of PPIs
Nexium (Esomeprazole)
Prilosec (Omeprazole)
Prevacid (Lansoprazole)
Dexilant (Dexlansoprazole)
Protonix (Pantoprazole)
AcipHex (Rabeprazole)

PPIs can be effective at stopping symptoms but they don’t actually stop the reflux, instead they alter the acidity of the stomach contents by blocking the site of acid production in the stomach cells – the proton pump.

Clinical studies have demonstrated that proton pump inhibitors are not effective in treating the symptoms of airway reflux, such as laryngopharyngeal reflux (LPR).

The long-term usage of PPIs has also been associated with serious health complications.

Therefore, you should only really be taking PPIs if you have a confirmed reflux diagnosis, not just because reflux is suspected. Using PPIs for more than four weeks can make it quite hard to come off the drug once you’re on it.

It is ideal to take samples for pepsin analysis using Peptest (RD Biomed UK) before taking new medication so that you can be sure that reflux is the cause. But many of our customers are already taking PPIs.

So, should you stop taking PPIs before using Peptest?

It is not necessary to stop proton pump inhibitors or H2 receptor antagonist therapy.

We do, however, recommend that you stop taking all antacid-type products and Gaviscon for 48 hours prior to taking samples for Peptest analysis.

Why is this?

We recommend that you stop taking antacids and raft-forming/alginate suspensions because they may prevent reflux or break down pepsin which will influence the outcome of the test.

Alginate, particularly Gaviscon, binds both pepsin and bile acids and prevents them from being refluxed into the oesophagus and airways.

It is not necessary to stop PPI or H2 receptor antagonist therapy as Peptest will still detect any refluxed pepsin in the presence of these. This is because PPIs do not prevent reflux from occurring they only prevent acid production.

Pepsin is active from pH 1 to pH 7 – which means it will still be active despite of taking acid-inhibiting PPIs.

You can read more about the role of Pepsin in reflux here.

In general, how easy is it to stop taking PPIs?

It can then be very difficult for someone who uses proton pump inhibitors for more than a month to come off the medicine.

Because the inhibitors prevent acid production, they can sometimes cause acid rebound so someone who didn’t actually have reflux to start with develops it because they now have an excess of acid.