Proton pump inhibitors use in short bowel patients at a Thai tertiary hospital; a 10-year retrospective observational study

Abstract

Background: Proton pump inhibitors (PPIs) reduce the gastric acid secretion in short bowel patients. However, the absorptive areas of these patients are limited. In case of residual jejunum length less than 50 cm, the intravenous administration of PPIs should be considered. 
Objective: To evaluate the appropriateness of PPIs use in short bowel patients regarding their remaining bowels. 
Methods: Data were collected from medication orders from 2008 to 2018 for short bowel patients admitted at King Chulalongkorn Memorial Hospital, Thailand. The medication costs were also evaluated. 
Results: Ten patients aged from newborn to 64 years were included. Six patients were undergone extensive bowel resection needing intravenous PPIs. From a total number of 340 medication orders, omeprazole was the only PPIs prescribed to the patients. In the two-thirds of prescriptions, the routes of PPIs administration were not appropriate according to the physiology of patients’ remaining bowels. They costed 235.20 USD or 7,301.00 baht. 
Conclusion: Inappropriate prescriptions of omeprazole in short bowel patients were found. However, there were unclear of patients’ clinical conditions and the limitations of medication administration in practice. Further studies about the cost-effectiveness of PPIs in short bowel patients should be warranted.