Everyone knows what Tylenol and Advil are, but have you heard of omeprazole before? According to GoodRx, a website offering coupons for prescription drugs, omeprazole was the 7th most popular drug prescribed in the United States as of November 2021. A systematic review by El-Serag et al. estimated that 18.1-27.8% of people in the United States have gastroesophageal reflux disease (GERD), a condition that causes acid reflux and heartburn. Omeprazole is commonly given to patients who suffer from GERD, which may explain why this drug is so high up on the list of prescribed medications.
Omeprazole functions as a “proton pump inhibitor“, which simply means it reduces the amount of acid in the stomach. In the stomach, parietal cells are stimulated by hormones like gastrin, acetylcholine, and histamine to secrete hydrochloric acid that actually helps the body digest food. The process of creating acid first begins with the parietal cells pumping out protons into the stomach. Those protons then bind to chloride ions that are also secreted by the parietal cells to make hydrochloric acid, which reduces the pH in the stomach and creates an acidic environment. Omeprazole is the perfect drug for treating GERD then because the acidic environment actually activates its ability to attach itself to proton pumps and decrease the number of protons exiting the cell. Ultimately, this reduces the amount of acid in the stomach.
In the case of GERD, the hydrochloric acid repeatedly splashes up into the esophagus and causes an uncomfortable burning sensation. The inhibition of the proton pump of parietal cells decreases the amount of acid in the stomach that can rise up to the esophagus and cause irritation. Some studies have indicated the effectiveness of taking omeprazole before a meal since the presence of food in the stomach activates the proton pumps.
Man with painful stomachache.
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In addition to GERD, omeprazole is also used to treat Zollinger-Ellison syndrome and peptic ulcer disease. Zollinger-Ellison syndrome is a rare condition where there are tumors in the small intestines that release gastrin, a hormone that induces the secretion of hydrochloric acid. This causes the parietal cells to release too much hydrochloric acid. Peptic ulcers are open sores in the stomach caused by either the H. pylori bacteria or by frequent pain reliever use. Omeprazole decreases hydrochloric acid levels and allows the open sores to heal.
While Omeprazole can be helpful in relieving stomach pain, it comes with some side effects, including headache, stomach pain, fatigue, nausea, constipation, and flatulence. The effects of long term use of omeprazole on patients are also concerning since it is widely available as an over-the-counter drug. Chronic omeprazole use can result in decreased absorption of calcium and magnesium and an increased risk of infections.
As with any medication, it is important to speak to your doctor about any concerns you may have. While omeprazole can be a great help with symptoms of GERD and other stomach problems, there are additional actions one can take to alleviate those symptoms, such as: eating small meals frequently, avoiding certain foods like tomatoes, garlic, alcohol, coffee, tea, greasy foods, or spicy foods, avoiding carbonated beverages, keeping yourself upright after eating, sleeping on an incline, and quitting smoking.
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