can omeprazole cause neuropathy

Any use of this site constitutes your agreement to the Terms of Use and Privacy Policy and Conditions of Use linked below. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. https://www.foundationforpn.org/what-is-peripheral-neuropathy/. Common side effects of Zegerid include: headache stomach or abdominal pain, nausea, gas, or. What's the worst that can happen, I get acid reflux? DIPN is more likely to occur in patients with concomitant risk factors such as preexisting neuropathy, diabetes, and associated genetically predisposing diseases. Can Omeprazole Cause Peripheral Neuropathy neuropathy Omeprazole works by decreasing the amount of acid your stomach produces. JAMA Neurol 2016;73:410-416). Nervous System/Psychiatric: Psychiatric and sleep disturbances including depression, agitation, aggression, hallucinations, confusion, insomnia, nervousness, They further speculated that increasing gastric pH with PPIs may reduce vitamin B12 absorption. Every nerve in your peripheral system has a specific function, so symptoms depend on the type of nerves affected. Neurobiol. and transmitted securely. If that happens, I can either re-start the PPI or try Pepcid for a while. 2014;115(2):185192. Most peoples body weight fluctuates over time, but rapid weight gain can sometimes indicate a medical issue. Neuropathy + Proton-pump Inhibitor use?? Anyone had Lett. This can help decrease your symptoms. Symptoms can include: seizures irregular or fast heart rate tremors jitteriness muscle This could cause the drug to build up in your bodyand increase your risk of side effects. Most of the omeprazoles side effects are mild and ease as your body gets used to the medication. Dont take this drug again if youve ever had an allergic reaction to it or other proton pump inhibitors. Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. Proton-pump inhibitor use is associated with a broad spectrum of neurological adverse events including impaired hearing, vision, and memory: Some reports may have incomplete information. Peripheral neuropathy is nerve damage caused by a number of different conditions. Philadelphia, Pa.: Elsevier; 2018. https://www.clinicalkey.com. 2014 Apr 27;2014(4):CD007938. Mylan Pharmaceuticals Inc (2003): 3. Symptoms can include: rash that may involve the skin of the nose, raised, red, scaly, red, or purple rash on your body. Our original studies have been referenced on 600+ medical publications including The Lancet, Mayo Clinic Proceedings, and Nature. Cerner Multum, Inc. "Australian Product Information." How Viagra became a new 'tool' for young men, Ankylosing Spondylitis Pain: Fact or Fiction, Omeprazole: 20-mg vs. 40-mg strength side effects, https://www.ncbi.nlm.nih.gov/books/NBK100895/, https://nctr-crs.fda.gov/fdalabel/services/spl/set-ids/afda9d2c-b141-4c32-a5b4-e850974b30a3/spl-doc, https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=fb3b1c3b-d486-4fa6-9ebf-ee1812ed2512, https://www.accessdata.fda.gov/scripts/cder/ob/index.cfm, https://www.accessdata.fda.gov/drugsatfda_docs/label/2022/022056s025lbl.pdf, https://nctr-crs.fda.gov/fdalabel/services/spl/set-ids/677f8593-7488-4fd8-94e7-103c743b00ea/spl-doc, New clues to slow aging? These drugs are often used to treat similar conditions. Unable to load your collection due to an error, Unable to load your delegates due to an error. Cisplatin preferentially binds to DNA in dorsal root ganglion neurons in vitro and in vivo: A potential mechanism for neurotoxicity. (2021). If you remember just a few hours before your next scheduled dose, take only one dose. It shouldnt be used in this age group. Prescription omeprazole oral capsule is a delayed-release drug. You could try from the beginning by taking the Prilosec again for a few days until the worst discomfort is over. information is beneficial, we may combine your email and website usage information with I have had idiopathic PN for 6. All rights reserved. Is the ketogenic diet right for autoimmune conditions? Learn more about GER and burping here. [Psychotic symptoms as a side-effect of omeprazole] - PubMed This drug hasnt been studied in children younger than 16 years. WebAbstract. As a result, more of a drug stays in your body for a longer time. Diarrhea was one of the more common side effects reported in clinical trials of omeprazole capsules. Dont store the mixture for later use. You may need to show airport staff the pharmacy label for your medication. This drug may not be the right treatment option for you if you have certain medical conditions or other factors that affect your health. Pharmacological Profile of MP-101, a Novel Non-racemic Mixture of R- and S-dimiracetam with Increased Potency in Rat Models of Cognition, Depression and Neuropathic Pain. Stomach or abdominal pain may occur while taking omeprazole. Available for Android and iOS devices. Can diet help improve depression symptoms? However, my biopsy was negative. Hello, I have been taking Nexium for 10 years and for the past 2 years Ive been experiencing neuropathic pain in my hands and now all over my body. WebProton pump inhibitor alternatives are medications and nondrug remedies that treat conditions such as acid reflux and heartburn. Complete your request online or contact us by phone. [Ref], Postmarketing reports: Hematuria, microscopic pyuria, proteinuria, testicular pain, urinary frequency, urinary tract infection[Ref], A causal relationship between this drug and impotence has not been established. What are the best ways to get rid of nausea? Learn more here. However, it can cause other side effects. 2005;18(2):305313. If you stop taking the drug suddenly or dont take it at all: Your acid reflux, heartburn, or ulcer symptoms may not improve. Anxiety wasnt reported in clinical trials of omeprazole capsules or tablets. This could lead to weight loss. Accessed April 3, 2019. If you develop a side effect while taking omeprazole and want to tell the FDA about it, visit MedWatch. Taking omeprazole could cause you to have another allergic reaction. Accessed March 26, 2019. WebThe phase IV clinical study analyzes which people take Omeprazole and have Peripheral sensory neuropathy. However, if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist. To my knowledge, this is the first report of metformin-induced vitamin B12 deficiency causing neuropathy. Overview of polyneuropathy. Omeprazole: Side effects, dosage, uses, and more Doing so can cause dangerous effects in the body. Most people with peripheral neuropathy have polyneuropathy. Among them, 121 people (0.03%) have Peripheral sensory neuropathy. All Rights Reserved. Repurposing MS immunotherapies for CIDP and other autoimmune neuropathies: unfulfilled promise or efficient strategy? FOIA Furthermore, we found significant associations of PPI use with a wide range of neurological adverse reactions including, migraine, several peripheral neuropathies, Neuropathy It could also worsen symptoms of the condition youre taking omeprazole to treat. http://www.ninds.nih.gov/disorders/peripheralneuropathy/detail_peripheralneuropathy.htm. Advanced techniques of neuromodulation offer promise though further randomized and controlled studies are needed to confirm efficacy. Our team thoroughly researches and evaluates the recommendations we make on our site. doi: 10.1016/j.neulet.2015.01.048. 40 mg taken once per day for 14 days with clarithromycin. doi: 10.1111/bcpt.12261. This drug should only be used if the potential benefit justifies the potential risk to the fetus. They can investigate the possible cause and suggest ways to maintain a weight that is healthy for you. If you already have osteoporosis, you already have an increased risk of bone fractures. Is the ketogenic diet right for autoimmune conditions? HHS Vulnerability Disclosure, Help Proton pump inhibitors linked to neurological conditions Drug-induced peripheral neuropathy is a common and painful condition caused by many different and frequently prescribed medications. Alternatives to Proton Pump Inhibitors (PPIs) for GERD @piross1528 I have identical symptoms it seems while on omeprazole for 3-4 years for GERD. My symptoms are stabbing/itchy needle like pains mostly in my legs and now hands. This included 80 reports of Alzheimer-type dementia with PPIs compared to none with H2 blockers. Always carry your medication with you. Cancer Wiley-Blackwell. This means you may need to take it with other medications. Seizures (including convulsions, epilepsy) and migraines were also more commonly reported with PPIs. This can help make sure you stay safe while you take this drug. Examples of these side effects are described throughout this article. Here are some frequently asked questions about the drugs side effects and their answers. For people with a vitamin B-12 deficiency: This drug reduces the amount of acid in your stomach. Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a healthcare professional. Smith EM, Pang H, Cirrincione C, Fleishman S, Paskett ED, Ahles T, Bressler LR, Fadul CE, Knox C, Le-Lindqwister N, Gilman PB, Shapiro CL; Alliance for Clinical Trials in Oncology. Clipboard, Search History, and several other advanced features are temporarily unavailable. Omeprazole (omeprazole)." Due to this risk, your doctor may prescribe a low omeprazole dosage. Conclusion: Has anyone here ever had a neuropathy they believed to be linked to PPI use? Sensory nerves that receive sensation, such as temperature, pain, vibration or touch, from the skin, Motor nerves that control muscle movement, Autonomic nerves that control functions such as blood pressure, perspiration, heart rate, digestion and bladder function, Gradual onset of numbness, prickling or tingling in your feet or hands, which can spread upward into your legs and arms, Sharp, jabbing, throbbing or burning pain, Pain during activities that shouldn't cause pain, such as pain in your feet when putting weight on them or when they're under a blanket, Feeling as if you're wearing gloves or socks when you're not, Excessive sweating or not being able to sweat, Drops in blood pressure, causing dizziness or lightheadedness, Diabetes, especially if your sugar levels are poorly controlled, Vitamin deficiencies, particularly B vitamins, Infections, such as Lyme disease, shingles, Epstein-Barr virus, hepatitis B and C, and HIV, Autoimmune diseases, such as rheumatoid arthritis and lupus, in which your immune system attacks your own tissues, Repetitive motion, such as those performed for certain jobs. "Hello Amanda, thank you for your response. With medical big data and proven AI algorithms, eHealthMe provides a platform for everyone to run phase IV clinical trials. If you have constipation while taking omeprazole, it will typically get better in a few days or weeks. To help avoid interactions, your doctor should manage all of your medications carefully. AAN 2023 HIGHLIGHTS WEDNESDAY, APRIL 26. Gomm et al. A prescription for this medication is refillable. It can also be a symptom of the conditions omeprazole is used to treat. Proton Pump Inhibitors Dont put this medication in your cars glove compartment or leave it in the car. (2022). Neurological examinations. -, Green S., Holton A. Drug-induced peripheral neuropathy. Dont worry about airport X-ray machines. Most often, DIPN is seen in chemotherapeutic agents, antimicrobials, cardiovascular drugs, psychotropic, and anticonvulsant drugs. INvesTigating the Abnormality of detrusor ConTractility by uroflowmetry in diabetic children (INTACT Trial): protocol of a prospective, observational study. Omeprazole may pass into breast milk in small amounts. It seems like my later doctors never want to take on questioning or changing what (now deceased) doctors did, and everything we do is just moving forward with new additions of drugs. Can omeprazole cause As with other drugs, omeprazole can cause side effects (adverse effects). Along with its needed effects, omeprazole may cause some unwanted effects. For seniors: The kidneys of older adults may not work as well as they used to. Antibiotics may also cause side effects. Omeprazole may cause several side effects. A new analysis of the FDA adverse events database (FAERS) has reported that use of proton pump inhibitors (e.g. Its not known whether this may cause side effects in a child whos breastfed. All rights reserved. [Ref], Rare (0.01% to 0.1%): Interstitial nephritis, Very rare (less than 0.01%): Impaired renal function, nephrosis, Postmarketing reports: Elevated serum creatinine, glycosuria[Ref], Frequency not reported: Irreversible visual impairment, Postmarketing reports: Anterior ischemic optic neuropathy, double vision, dry eye syndrome, ocular irritation, optic atrophy, optic neuritis[Ref], Irreversible visual impairment has been reported in critically ill patients who generally received high doses of the IV formulation as a bolus; however, no causal relationship has been established. Gastroesophageal reflux (GER) can cause a person to belch. @piross1528 I don't know if you've come across this paper, but thought I'd share in case it helps you as you continue to explore the connection. If you take one of these medications, your doctor will likely recommend that you do not take omeprazole. What foods should I avoid when taking omeprazole? Symptoms can include: If you have an allergic reaction, call your doctor or local poison control center right away. If your child has been prescribed omeprazole and youre concerned about side effects, talk with their doctor. This information is not a substitute for medical advice. OTC omeprazole is used to treat heartburn in adults. The side effects from this drug are slightly different for children and adults. Peripheral neuropathies. They can try to determine its cause. For pregnant women: There isnt enough good information on the use of omeprazole in pregnant women to determine the risk to a pregnancy. This site needs JavaScript to work properly. For people of Asian descent: Your doctor may give you a lower dosage of this medication, especially if youre taking it for erosive esophagitis. Vilholm OJ, Christensen AA, Zedan AH, Itani M. Basic Clin Pharmacol Toxicol. It doesnt have a brand-name version. Keep them between 59F and 86F (15C and 30C). These include an allergic reaction to omeprazole, any of its ingredients, or other proton pump inhibitor drugs. However, my serum B12 levels are high. If your doctor prescribes omeprazole for longer than a year, talk with them about your risk of bone fractures. Systemic lupus erythematosus (SLE). Examples of these drugs include: 20 mg taken twice per day for 10 days with amoxicillin and clarithromycin. Over-the-counter omeprazole comes as delayed-release (DR)* tablets and capsules in a strength of 20 milligrams (mg). There are other drugs available to treat your condition. His heartburn was exacerbated if he overate, but he took the omeprazole daily, with or without overt symptoms. Additionally, the patient described himself as a heavy alcohol drinker, ingesting 2-3 glasses of beer or whiskey daily for the past 15 years. B12-induced peripheral neuropathy has been well documented in the literature. This dosage information is for omeprazole oral capsule. "Product Information. Have you shared your thoughts with your doctor? Symptoms can be mild or serious and can include: For mild symptoms of an allergic reaction, call your doctor right away. My PPI is a med, along with one other prescribed 19 yrs ago, that I wonder if it ever was actually needed and if they can be stopped. Omeprazole oral capsule is a prescription drug thats only available in a generic form. You'll soon start receiving the latest Mayo Clinic health information you requested in your inbox. Mild side effects that have been reported with omeprazole include: These side effects may be temporary, lasting a few days to weeks. They may recommend ways to ease your symptoms and determine whether you should keep taking omeprazole. This condition may be a manifestation of the underlying condition, which is known to be associated with tumors.[Ref]. How Viagra became a new 'tool' for young men, Ankylosing Spondylitis Pain: Fact or Fiction, Omeprazole may interact with other medications, Important considerations for taking omeprazole, https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=581d1c3d-457a-41f2-8db0-5b6219cdcb09, New clues to slow aging? I stopped the prosilec abruptly..I know now it was not the right choice but I do not want to take it ..was on the med for over 6 years..I am taking pepcid and fgard..but still having rebound acid..I will go get gaviscon and try that..hopefully it will get betterthank you for the information. It doesnt have a brand-name version. The conditions and factors to consider include: Allergic reaction. Different individuals may respond to medication in different ways. We avoid using tertiary references. Prevacid Side Effects This was among the more common side effects reported in clinical trials of omeprazole capsules. As with all medications, the costs of omeprazole can vary. Low magnesium levels can be associated with long-term use of PPIs Here are some other tips for managing nausea: If you have nausea thats bothersome, severe, or doesnt go away, talk with your doctor. [Ref], Rare (0.01% to 0.1%): Aggression, agitation, confusion/reversible mental confusion, depression, hallucinations, Postmarketing reports: Anxiety, apathy, dream abnormalities, nervousness, psychiatric and sleep disturbances[Ref], Uncommon (0.1% to 1%): Increased liver enzymes (ALT, alkaline phosphatase, AST, bilirubin, gamma glutamyl transferase), Rare (0.01% to 0.1%): Hepatic failure, hepatitis with/without jaundice, Postmarketing reports: Cholestatic disease, fatal hepatic failure, hepatocellular disease, jaundice, liver disease, liver necrosis (some fatal), mixed hepatitis[Ref], Postmarketing reports: Bradycardia, chest pain/angina, elevated blood pressure/hypertension, palpitations, tachycardia[Ref], Peripheral edema usually resolved when treatment was stopped. Nexium vs Prilosec: What's the difference between them? information submitted for this request. "Product Information. If your symptoms are severe, call 911 or go to the nearest emergency room. WebPeripheral neuropathy is found among people who take Naproxen, especially for people who are male, 60+ old. What to do if you miss a dose: Take your dose as soon as you remember. Bethesda, MD 20894, Web Policies Side effects arent especially common with omeprazole. The drug has been in use for some 10 years and appears to be safe for long term use. Peripheral neuropathy - Symptoms and causes - Mayo Clinic [Ref], Rare (0.01% to 0.1%): Agranulocytosis, hypochromic/microcytic anemia, leukopenia, pancytopenia, thrombocytopenia, Postmarketing reports: Anemia, fatal agranulocytosis, hemolytic anemia, leukocytosis, neutropenia, purpura[Ref], Rare (0.01% to 0.1%): Anaphylactic reaction/shock, angioedema, hypersensitivity reactions, Very rare (less than 0.01%): Hypocalcemia, hypokalemia, hypomagnesemia with/without hypocalcemia and/or hypokalemia, weight increase, Postmarketing reports: Anorexia, cyanocobalamin (vitamin B12) deficiency, hypoglycemia[Ref]. Is famotidine safer than omeprazole for heartburn? All possible dosages and drug forms may not be included here. Check with your doctor immediately if any of the following side effects occur while taking omeprazole: Rare Back, leg, or stomach pain bleeding or crusting sores on Omeprazole tablet, delayed release. other information we have about you. anterior ischemic optic neuropathy, optic neuritis, dry eye syndrome, ocular irritation, Valtrex Online & Buy Valacyclovir Tablets Certain medications have been implicated in the iatrogenic development of Drug Induced Peripheral Neuropathy (DIPN) and include chemotherapeutic agents, antimicrobials, cardiovascular drugs, psychotropic, anticonvulsants, among others. Bonifacino T, Micheli L, Torazza C, Ghelardini C, Farina C, Bonanno G, Milanese M, Di Cesare Mannelli L, Scherz MW. The Foundation for Peripheral Neuropathy. Learn more about some of the side effects that omeprazole may cause. Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press. Due to this risk, your doctor may prescribe a low omeprazole dosage* if you have liver problems. Talk with them about what other drugs may be better options for you. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them: Applies to omeprazole: compounding powder, oral delayed release capsule, oral delayed release tablet, oral powder for reconstitution, oral powder for reconstitution delayed release, oral suspension, oral tablet disintegrating delayed release. Medically reviewed by Drugs.com. Weight gain has been reported in some people taking omeprazole since the drug was approved. Drug induced peripheral neuropathy; chemotherapy; gabapentinoids; pain; paresthesia; statins; weakness.. Copyright Bentham Science Publishers; For any queries, please email at epub@benthamscience.net. I have had night sweats, facial itching, had and feet numbness and tingling, then even some imbalance and stumbling. People with peripheral neuropathy generally describe the pain as stabbing, burning or tingling. Lightheadedness occurred predominantly in severely ill or elderly patients. It may help to take the medication with a meal or snack. https://www.foundationforpn.org/what-is-peripheral-neuropathy/causes/. This includes kidney problems. Benign gastric fundic gland polyps appeared to be reversible when omeprazole was discontinued. https://www.foundationforpn.org/what-is-peripheral-neuropathy/causes/. Front Neurol 2019;9:1142). If you develop low levels, your doctor will likely prescribe supplements to correct them. * Approximation only. Your doctor may prescribe antibiotics or other treatments if you have diarrhea caused by a C. diff infection. Kachrani R, Santana A, Rogala B, Pawasauskas J. J Pain Palliat Care Pharmacother. 2020 Jun;38(1):145-162. doi: 10.1007/s12640-020-00176-2. Always carry the original prescription-labeled container with you. These issues include: Not every pharmacy stocks this drug. Its not clear whether this side effect occurred in clinical trials of omeprazole tablets. There are a variety of medicines available for the treatment of acid reflux. This is the protocol I was given by my pharmacist when I was finally able to stop taking Protonix. A new analysis of the FDA adverse events database (FAERS) has reported that use of proton pump inhibitors (e.g. This raises your risk of side effects. (Omeprazole belongs to the proton pump inhibitor drug class.) Side Effects of Prilosec (omeprazole): Interactions & Warnings The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. Moore RA, Wiffen PJ, Derry S, Toelle T, Rice AS. Metformin-induced vitamin B12 deficiency presenting If it does nothing to reduce my PN discomfort, at least I might find out after 10 years if I really have acid reflux! Prilosec (omeprazole magnesium) for delayed-release oral suspension. They may even get worse. Proton-pump inhibitor use is associated with a broad spectrum of A class of drugs is a group of medications that work in a similar way. Store the capsules at room temperature. 2013 Apr 3;309(13):1359-67. doi: 10.1001/jama.2013.2813. Dont chew or crush the capsules. Prevention of DIPN is especially important because treatment often proves challenging. People of Asian descent. Note that constipation could be a symptom of a low vitamin B12 level, which may be associated with long-term use of omeprazole. Always speak with your doctor or pharmacist about dosages that are right for you. It shouldnt be used in people younger than 16 years. However, omeprazole can sometimes cause a bacterial infection due to Clostridium difficile (C. diff) bacteria in your intestines. Keywords: These side effects may be temporary, lasting a few days to weeks. If youre concerned about weight changes with omeprazole, talk with your doctor. Have had peripheral neuropathy and even have been getting treated with IVIG. The site is secure. If you have one of these conditions, talk with your doctor about whether omeprazole is safe for you. All rights reserved. They cant hurt your medication. Medication and surgery can treat. government site. These drugs are typically prescribed to lower cholesterol and thereby reduce the risk of heart attack and stroke. How soon after taking levothyroxine can I take omeprazole? Ask your doctor what other medications may be better options for you. Examples of other proton pump inhibitor drugs include esomeprazole (Nexium) and lansoprazole (Prevacid). Scientists use genetic rewiring to increase lifespan of cells, Beyond amyloid and tau: New targets in developing dementia treatments, Napping longer than 30 minutes linked to higher risk of obesity and high blood pressure, Activity 'snacks' could lower blood sugar, complication risk in type 1 diabetes, In Conversation: Investigating the power of music for dementia. Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. Before I have been using Omeprazole (Proron pump anhibitor) for over 20 years for GERD, during the 30 years before that I ate thousands of Tums and Rolaids. I have already read this paper and am not sure what to make of it! If theyre more severe or dont go away, talk to your doctor or pharmacist. They may want to investigate possible causes. MNT is the registered trade mark of Healthline Media. Hypokalemia was reported in pediatric patients. I had some very similar symptoms in 2018I stopped taking the PPI and they resolved. (2022). WebOmeprazole controls acid production in the stomach only and does not affect the acid/alkaline balance of the body. Accessed March 27, 2019. Feldman EL, et al. This is because the amount of omeprazole in your body is increased. Examples of drugs that can cause interactions with omeprazole are listed below. * For details about nausea and diarrhea with omeprazole, see the Omeprazole: Side effect specifics section below. Publication types Case Reports MeSH terms Aged This review synthesizes current clinical concepts regarding the mechanism, common inciting medications, and treatment options for drug-induced peripheral neuropathy. Your doctor will write the number of refills authorized on your prescription. If you miss doses or dont take the drug on schedule: Your medication may not work as well or may stop working completely. Accessibility Childrens side effects can include the above, plus the following: Vitamin B-12 deficiency. Wishing you the best. eCollection 2022. doi: 10.1016/j.nbd.2004.09.013. Last medically reviewed on September 1, 2021, Dexilant (dexlansoprazole) is a prescription drug thats used to treat gastroesophageal reflux disease (GERD). Omeprazole delayed-release capsules, for oral use. Side effects from other drugs: Taking omeprazole with certain medications raises your risk of side effects from these drugs. Examples of these drugs include: Saquinavir. Omeprazole may greatly increase the levels of saquinavir in your body. Your doctor may lower your dose of saquinavir. Digoxin. Other medications. Accidental injury most commonly occurred in patients 2 to 16 years of age. Wondering if it could be the omeprazole now. Also, contact them if you have other symptoms, such as a fever, or blood or pus in your stool. All my blood tests come back fine, including my B12 levels. Along with its needed effects, omeprazole/sodium bicarbonate may cause some unwanted effects. A review earlier this also raised concerns about the widespread use of PPIs, which are available over-the-counter in many countries, and the possible neurological sequelae associated with chronic PPI use (Novotny et al.
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