⚠️ Omeprazole and PPIs: What’s Behind the Recent Warning?

Recently, several newspapers – including The Mirror – reported that a “BBC doctor” had issued a warning to anyone taking omeprazole, a commonly prescribed drug for acid reflux and heartburn.
So, is this something new, or just another media scare? Let’s look at what the evidence actually says – and what it means if you’re living with aspergillosis, bronchiectasis, or other chronic lung diseases.

💊 What Are PPIs?

Proton Pump Inhibitors (PPIs) such as omeprazole, lansoprazole, and esomeprazole are medicines that reduce stomach acid.
They’re often used to:

• Treat reflux, indigestion, or stomach ulcers

• Protect the stomach from irritation caused by anti-inflammatory drugs or steroids

They’re very effective and widely prescribed — millions of people in the UK take them every day.

⚠️ Why the Headlines?

The recent news stories stem from a discussion on BBC Morning Live, where GP Dr Punam Krishan highlighted the potential long-term side effects of PPIs.
Although these aren’t “new discoveries”, they serve as an important reminder that long-term PPI use should be reviewed regularly.

🧠 What the Evidence Shows

Research over the past decade has shown that taking PPIs for a long time or at high doses can lead to several possible side effects:

Most of these risks are small, and for many people the benefits outweigh them — but it’s still important to make sure you’re taking the lowest effective dose and that your doctor reviews the need for it periodically.

🫁 Why It Matters for Aspergillosis and Lung Conditions

If you have aspergillosis, bronchiectasis, or Primary Ciliary Dyskinesia (PCD), there are extra reasons to think carefully about long-term PPI use:

• Microbiome connections: The gut and lungs are linked through what’s called the gut–lung axis. Disturbances in gut bacteria can affect immune responses elsewhere in the body — possibly including the lungs.

• Infection control: PPIs can slightly increase the risk of bacterial or fungal overgrowth in the gut. While this doesn’t directly cause lung infection, it may influence the body’s balance between helpful and harmful microbes.

• Medication interactions: Some antifungal medicines (like itraconazole or posaconazole) rely on stomach acidity for absorption — so PPIs can reduce their effectiveness. Your specialist will usually time doses or adjust medication accordingly.

• Reflux and aspiration: On the other hand, reflux itself can worsen lung disease if acid is inhaled into the lungs — so stopping PPIs suddenly can make things worse. Always discuss any change with your doctor first.

🩺 What You Can Do

If you take omeprazole or another PPI:

1. Check why you’re on it – Is it for reflux, ulcer protection, or another reason?

2. Review the dose and duration – Many people can step down to a lower dose or switch to on-demand use once symptoms are controlled.

3. Don’t stop suddenly – Stopping PPIs abruptly can cause a rebound in acid production and make symptoms flare.

4. Ask about alternatives – Some people can switch to H2-blockers (e.g. ranitidine-type medicines), or use lifestyle changes such as avoiding late meals, raising the bedhead, and reducing caffeine or alcohol.

5. Discuss with your specialist team – Particularly if you’re also on antifungal or antibiotic treatments, as interactions can occur.

🧩 Key Takeaway

The recent headlines about omeprazole are not new, but they highlight a genuine issue:
PPIs are very useful drugs — but long-term use should always be reviewed to make sure the benefits outweigh the risks.

For most people, there’s no need to panic.
Just make sure you:

• Use the lowest effective dose

• Review your need for PPIs at least once a year

• Discuss any concerns with your respiratory or gastroenterology team

🔗 Useful References

• NHS Guidance: Proton Pump Inhibitors – Risks and Review Advice

• PrescQIPP PPI Safety Review (UK 2023) – Long-term safety and deprescribing guidance

• Gut (BMJ): Proton pump inhibitors and gut microbiota: cause for concern? (Gut 2016;65:740–748)