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Is long term use of proton pump inhibitors safe? Although PPIs have had an encouraging safety profile, recent studies regarding the long - term use of PPI medications have noted potential adverse effects, including risk of fractures, pneumonia, Clostridium difficile diarrhea, hypomagnesemia, vitamin B 12 deficiency, chronic kidney disease, and dementia. What causes nodules in rheumatoid arthritis? Rheumatoid nodules are firm lumps that appear subcutaneously (ie under the skin) in up to 20% of patients with rheumatoid arthritis. They are usually non-tender and only occasionally painful and very rarely the overlying skin can become infected or even ulcerate. Rarely they can occur in the lungs and vocal cords.
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