Peter Hyrdel, Peter Bánovčin, Martin Schnierer, Rudolf Hyrdel
Hydrochloric acid plays various physiological roles in the stomach. Most of all it is its disinfection, antibacterial role, supportive role in digestion of proteins, it activates digestive enzymes and helps in kobaltamine, calcium and iron absorbsion. Long term absence of HCl in gastric juice as a result of PPI therapy can manifest by increased possibility of infection, bone fractures, chronic anaemia of combined aetiology. Not only a lack of acid can trigger pathological processes but also PPI can contribute to pathology in bones inhibiting transport of protons in osteoclasts. Elderly population is evidently a risk group in which a PPI therapy should be indicated only in justifiable cases.