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Pharmacy/high protein meal after taking ppi's

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QUESTION: I am taking one of the proton pump inhibitors to reduce stomach acid. I read more than one study that says it is important not only to eat one hour after taking it, but to eat a meal high in protein, to maximize the effectiveness of the drug ("Without sufficient protein in the meal following PPI intake, only about 10% of the proton pumps will be stimulated.") It suggests high protein foods like milk, cheese, yogurt. But does it need to be solid food, or would a high protein shake/drink made from powder accomplish the same goal?  Thank you

ANSWER: Lee

I'm afraid I have never heard of the need for high protein intake whilst taking a PPI. Certainly there is no such reference in the UK datasheet.

Whilst the (near) total acid suppression that is produced by PPI use, adding in extra protein doesn't seem logical as it means a smaller proportion of the whole is likely to be digested. Anyone eating a normal diet should not become protein deficient through use of a PPI - many thousands of patients use them almost continuously and show no signs of deficiency.

Has the information you cite come from a credible reference source (Medline, FDA etc.) or from pseudo-medical sites, where information is often inaccurate and written by non-clinicians with other motives (e.g. selling dietary supplements)?

If you can provide the references, I can review them and comment further.

---------- FOLLOW-UP ----------

QUESTION: I included the link to the study, it's by an M.D. of internal medicine and was published in Practical Gastroenterology. I've read elsewhere about eating an hour after taking ppi's, especially eating protein, and not only to give the drug time to be absorbed. The point was not that ppi's make one deficient in protein, but that eating that helps to activate them and make them work more effectively. In the study attached, it says if you don't do that the ppi is only 10% effective. See what you think.

http://www.practicalgastro.com/pdf/January07/Jan07FrankArticle.pdf

Answer
Lee

The point is that protein stimulates the acid producing cells in the stomach, so the PPI can be more effective. I wouldn't say a high protein diet is critical, but protein may mean that the PPI is effective earlier, so speeding healing.

I don't think there is a need for significant protein intake above normal, the message from the editorial is to include a reasonable amount of protein in breakfast - and not just starches from toast etc. Cereal with milk, or simply a reasonably sized glass of milk (whichever fat content you prefer as protein content will be similar) will probably be sufficient.

It is not worth wasting money on special high protein drinks - they are never really needed by the vast majority of people. It's just marketed that way.

Ultimately the decision is yours, but I wouldn't say an extreme change in protein consumption is necessary.

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Nigel Simmons

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I am happy to answer general questions on medicines and hospital care. If possible, please use approved / chemical names rather than brands which are not internationally recognised. Like all health professionals I am bound by a duty of care which prevents me giving detailed information about medication or treatment of people other than the questioner. I will endeavour to help wherever possible or point towards more appropriate advice. If however your question crosses too far into patient confidentiality, I hope you will understand why I cannot answer your question. Consider.. would you want me to discuss your care with a friend or relative without your knowledge?

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