Proton pump inhibitors: A possible effect on Ménière's disease?

Background: The model of explanation for the pathogenesis of Ménière's disease (MD) proposed by our group postulates a crucial role for the maintained activity of the labyrinthine gastric-type proton pump under ischaemic conditions. Thus, the administration of the common proton pump inhibitors (PPI) could exert a favourable influence on MD symptoms. Method: In order to help assess the validity of this hypothesis a questionnaire was administered to a selected population of sufferers from MD; the aim was to verify the percentage of PPI users and the incidence of MD symptoms among users and non-users. Results: These showed a higher prevalence of PPI users in the selected sample compared to an unselected large series in the literature; the difference was statistically significant in all cases. In contrast, no statistically significant differences between users and non-users were found regarding the incidence of symptoms in the previous six months, even though the group of PPI users had a slightly better performance. Conclusion: Despite these inconclusive findings and the consequent need for further studies to eventually propose PPI as a therapy for MD, some physiological and pharmacological aspects seem to support a possible positive influence of this category of drugs on the inner ear.