Summary e development of pharmaceutical agents reducing gastric acidity such as sucralfate, histamine 2 (H2) receptor blockers, and proton pump inhibitors
(PPIs) has been a milestone for the treatment of dys-peptic disorders. However, due to current prescrip-tion habits resulting in overuse of these potent
drugs as well as over-the-counter (OTC) availability associated with self-medication, substantial health concern is related to the mechanisms of drug action as well as known side eects in uencing gastro-intestinal physiology.
More than a decade ago, the €rst study appeared re-porting an association between anti-ulcer drug in-take and food allergy development. Since then, severalexperimental and human studies veri€ed this correlation, demonstrating that acid suppressive drugs not only in uence the sensitization capacity oforally ingested proteins, but also represent a risk factor for food allergic patients. Additionally, gas-tric acid suppression was reported to increase the risk for development of drug hypersensitivity reac-tions. ese consequences of anti-ulcer drug intake might on the one hand be associated with direct in uence of these drugs on immune responses. On the other hand reduction of gastric acidity leads to impaired gastrointestinal protein degradation. Never-theless, also disruption of the gastrointestinal bar-rier function, changes in microbiome, or lack of tolerogenic peptic digests might contribute to the connection between anti-ulcer drug intake and allergic reaction. erefore, these drugs should only be prescribed based on a precise gastroenterologi-cal diagnosis taking into consideration allergologi-cal mechanisms to ensure patients’ safety.