Eventos adversos gastrointestinales asociados al uso no prescrito de omeprazol en el primer nivel de atención: una revisión de alcance
Resumen
Objetivo: Sintetizar la evidencia científica disponible sobre los eventos adversos gastrointestinales derivados del uso crónico no prescrito de omeprazol en el primer nivel de atención, identificando riesgos clínicos y vacíos de conocimiento. Metodología: Revisión de alcance metodológica fundamentada en el marco de Arksey y O’Malley y la declaración PRISMA-ScR. Se ejecutaron búsquedas sistemáticas en PubMed, Scopus y Web of Science (2014-2026). Se incluyeron estudios observacionales, metaanálisis y reportes de farmacovigilancia sobre adultos expuestos a inhibidores de la bomba de protones mediante automedicación. Resultados: La exposición crónica genera hipoclorhidria iatrogénica, suprimiendo la barrera bactericida fisiológica y propiciando disbiosis entérica. Se constató un incremento del sobrecrecimiento bacteriano en el intestino delgado (odds ratio de 3,93) y una mayor susceptibilidad a infecciones por Clostridioides difficile, Campylobacter y Salmonella. A nivel metabólico y estructural, el uso superior a doce meses se asocia con malabsorción de vitamina B12, hierro y magnesio, así como con hipergastrinemia reactiva y formación de pólipos de glándulas fúndicas. Conclusiones: La automedicación con omeprazol en la comunidad constituye un factor de riesgo para morbilidad digestiva e infecciosa. Resulta imperativo implementar protocolos estructurados de desprescripción y fortalecer la educación sanitaria en atención primaria.
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Derechos de autor 2026 Dayana Yamileth Aguilar Romero , Thalia Nectsay Vélez Pantoja, Julio Cesar Lojan Alvarado
Esta obra está bajo licencia internacional Creative Commons Reconocimiento 4.0.
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