What potential issue arises from chronic proton pump inhibitor use?

Chronic use of proton pump inhibitors (PPIs) can lead to decreased absorption of vitamin B12. This is primarily due to the role stomach acid plays in the absorption of vitamin B12, which is bound to protein in food. Proton pump inhibitors reduce the production of stomach acid, which can impede the release of vitamin B12 from its protein complex, making it less bioavailable for absorption in the intestines. Over time, this can result in vitamin B12 deficiency, leading to potential complications such as megaloblastic anemia and neurological issues.

While decreased absorption of calcium, increased risk of gastrointestinal infections, and malabsorption of iron are also associated with chronic PPI use, the specific issue relating to vitamin B12 deficiency is particularly significant as it can have serious health consequences if left unaddressed, making it critical for healthcare providers to monitor patients on long-term PPI therapy.