Indications for long-term use of proton pump inhibitors

Definitive (> 8 weeks)Conditional
Barrett esophagus (unrelated to GERD symptoms or esophagitis)PPI-responsive, endoscopy-negative reflux disease with recurrence on PPI cessation
Erosive esophagitis Los Angeles classification grade C/DPPI-responsive functional dyspepsia with recurrence on PPI cessation
Esophageal stricture due to GERDPPI-responsive upper-airway symptoms with recurrence on PPI cessation
NSAID/antiplatelet users with increased risk of ulcers and bleedingRefractory steatorrhea in chronic pancreatic insufficiency with enzyme replacement
Eosinophilic esophagitisSecondary prevention of peptic ulcers without concomitant antiplatelet drugs
Pathological hypersecretory conditions (Zollinger-Ellison syndrome)
Prevention of progression of idiopathic pulmonary fibrosis
  • GERD = gastroesophageal reflux disease; NSAID = nonsteroidal anti-inflammatory drug; PPI = proton pump inhibitors

  • Based on information in references 21 and 22.