ESOPHAGUS: Edited by Stuart J. SpechlerHow to advise patients on the risk of chronic proton pump inhibitor therapyMoayyedi, PaulAuthor Information Department of Medicine, Division of Gastroenterology, McMaster University, Hamilton, Ontario, Canada Correspondence to Paul Moayyedi, BSc MB ChB PhD MPH FRCP FRCPC AGAF, FACG, CAGF, Department of Medicine, Division of Gastroenterology, McMaster University, 1280 Main St. W. HSC 3V3, Hamilton, ON, Canada L8S 4K1. Tel: +1 905 521 2100x76764; fax: +1 905 521 4958; e-mail: email@example.com Current Opinion in Gastroenterology: July 2020 - Volume 36 - Issue 4 - p 317-322 doi: 10.1097/MOG.0000000000000641 Buy Metrics Abstract Purpose of review Proton pump inhibitors (PPIs) are widely prescribed and have excellent short-term tolerability. Administrative database studies have highlighted that many diseases are associated with PPI therapy including pneumonia, fracture, cardiovascular disease, and all-cause mortality. This review therefore reviews the evidence of the risks and benefits of these drugs. Recent findings There is high-to-moderate quality evidence that PPIs are effective at treating many acid-related disorders. Recent randomized trials have suggested that the associations between PPIs and various diseases are likely to be related to bias and residual confounding and these drugs appear to be safe apart from a possible increased risk of enteric infections. Summary PPIs should be used at the lowest dose and for the shortest duration possible. They are still relatively well-tolerated drugs but should only be prescribed for proven indications. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.