Proton pump inhibitors do not accelerate the development of gastric atrophy in Helicobacter pylori gastritis

Kuipers and colleagues1 suggested in 1996 that long-term acid suppression by omeprazole accelerates the development of atrophic gastritis in patients infected with Helicobacter pylori. This, in turn, may facilitate the development of intestinal metaplasia, dysplasia, and gastric adenocarcinoma. This report received widespread media attention because of the public perception, particularly in the United States, that the increasing use of proton pump inhibitors (PPIs), already suspected to be carcinogenic, would cause even more cancer, given the ubiquity of H. pylori infection and gastro-oesophageal reflux disease (GERD) in the general population. The Food and Drug Administration (FDA) convened an urgent meeting to determine if PPIs should be removed from the market or have substantial changes in approved indications and directions for use.