<prompt> All of the following adverse effects are associated with the use of proton pump inhibitors except:Community acquired pnemoniaClostridium difficile infectionOsteoporosis leading to hip fracturesHypothyroidism  <response>: Long term use of proton pump inhibitors may lead to : -Mild to moderate decrease in vitamin B12,iron and calcium absorption. -increased risk of enteric infections including C.difficile and bacterial gastroenteritis. -modest increase in risk of hip fractures. -modest increase in risk of pnemonia. Ref.CMDT 2015609-610 