Document Detail


Proton pump inhibitors and pain.
MedLine Citation:
PMID:  19935988     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
There may be a relationship between proton pump inhibitors (PPIs) and iron absorption. PPIs may decrease the amount of iron absorbed gastrointestinally specifically due to alteration of the pH in the duodenum. Restless legs syndrome (RLS) is a sensorimotor disorder that includes an urge to move legs, accompanied or caused by uncomfortable and unpleasant sensations in the legs; the urge to move begins or worsens during periods of rest or inactivity, the urge to move is partially or totally relieved by movement, and the urge is worse or only occurs at night. In the majority of the restless leg syndrome population, the sensation is deep seated, often described as being in the shin bones, and most commonly felt between the knee and ankle. It may be described as a creepy, shock-like, tense, electric, buzzing, itchy, or even numb sensation. A subpopulation of this restless leg syndrome patient population experiences restless leg syndrome associated pain (RLSAP) that has been described as a deep "achy pain." This pain has not been found to be relieved by many of the typical over the counter analgesics. Often, constant movement of the legs appears to be the only remedy, as these sensations usually appear during periods of rest. Furthermore, there appears to be an association between iron deficiency and those suffering from Restless Leg Syndrome (RLS). The authors theorize that there may be a possible correlation between PPIs and the symptoms (e.g. pain) associated with RLS. The authors propose that PPIs, such as omeprazole, may interfere with iron absorption in certain patients and that a subpopulation of patients who develop significant iron deficiency characterized by low serum ferritin levels while on PPIs may also develop RLS-like symptoms (including RLSAP). While there is no robust direct evidence to support any associations of PPIs and iron deficiency or PPIs associated with RLS-like symptoms (including RLSAP), it is hoped that this manuscript may spark research efforts on this issue.
Authors:
Howard S Smith; Reena Dhingra; Lori Ryckewaert; Dave Bonner
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pain physician     Volume:  12     ISSN:  2150-1149     ISO Abbreviation:  Pain Physician     Publication Date:    2009 Nov-Dec
Date Detail:
Created Date:  2009-11-25     Completed Date:  2010-02-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100954394     Medline TA:  Pain Physician     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1013-23     Citation Subset:  IM    
Affiliation:
Albany Medical College, Department of Anesthesiology, Albany, NY 12208, USA. smithh@mail.amc.edu
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MeSH Terms
Descriptor/Qualifier:
Analgesics, Opioid / metabolism
Animals
Humans
Iron / deficiency,  metabolism
Neuralgia / complications,  drug therapy*,  etiology
Proton Pump Inhibitors / pharmacology,  therapeutic use*
Restless Legs Syndrome / complications,  drug therapy*,  etiology
Chemical
Reg. No./Substance:
0/Analgesics, Opioid; 0/Proton Pump Inhibitors; 7439-89-6/Iron

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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