PPI-Induced Hypomagnesemia and Vitamin B12 Deficiency

Diagnosis and Management

• The American Gastroenterological Association recommends that if PPI therapy is continued in a patient with unproven GERD, clinicians should evaluate appropriateness and dosing within 12 months after initiation 1
• Clinicians should strongly consider PPI discontinuation or de-escalation after addressing acute electrolyte and nutritional deficiencies in patients with symptoms likely related to medication rather than GERD 2, 3
• Extraesophageal manifestations of GERD do not typically include weakness, tingling, or visual problems, and clinicians should not assume GERD symptoms are causing neurologic symptoms 4, 5