What are the effects of proton pump inhibitors on the small intestine?
Open accessAbstract
Generally, proton-pump inhibitors (PPIs) have great benefit for patients with acid related disease with less frequently occurring side effects. According to a recent report, PPIs provoke dysbiosis of the small intestinal bacterial flora, exacerbating nonsteroidal anti-inflammatory drug-induced small intestinal injury. Several meta-analyses and systematic reviews have reported that patients treated with PPIs, as well as post-gastrectomy patients, have a higher frequency of small intestinal bacterial overgrowth (SIBO) compared to patients who lack the aforementioned conditions. Furthermore, there is insufficient evidence that these conditions induce Clostridium difficile infection. At this time, PPI-induced dysbiosis is considered a type of SIBO. It now seems likely that intestinal bacterial flora influence many diseases, such as inflammatory bowel disease, diabetes mellitus, obesity, non-alcoholic fatty liver disease, and autoimmune diseases. When attempting to control intestinal bacterial flora with probiotics, prebiotics, and fecal microbiota transplantation, etc., the influence of acid suppression therapy, especially PPIs, should not be overlooked.
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Chronic treatment with PPIs strongly impacts small intestine microbiota and, in particular, causes small intestinal bacterial overgrowth (SIBO), likely due to the loss of the gastric acid defensive barrier.
“Chronic treatment with PPIs strongly impacts small intestine microbiota and, in particular, causes small intestinal bacterial overgrowth (SIBO), likely due to the loss of the gastric acid defensive barrier[81-83].”
From Proton pump inhibitors and dysbiosis: current knowledge and aspects to be clarified (2019) · cites this paper as [81]
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Inflammasome-mediated dysbiosis regulates progression of NAFLD and obesity
Henao-Mejia, J., Elinav, E., Jin, C., Hao, L., Mehal, W. Z., Strowig, T., Thaiss, C. A., Kau, A. L., Eisenbarth, S. C., Jurczak, M. J., et al. (2012) · Nature · doi:10.1038/nature10809 · Cited by 2,435 · see citing works
Microbiota and diabetes: an evolving relationship
Tilg, H., & Moschen, A. R. (2014) · Gut · doi:10.1136/gutjnl-2014-306928 · Cited by 853 · see citing works
Dysbiosis in inflammatory bowel disease
Tamboli, C. P., Neut, C., Desreumaux, P., & Colombel, J. F. (2004) · Gut · doi:10.1136/gut.53.1.1 · Cited by 743 · see citing works
Goldstein, J. L., Eisen, G. M., Lewis, B. S., Gralnek, I. M., Zlotnick, S., & Fort, J. G. (2005) · Clinical Gastroenterology and Hepatology · doi:10.1016/s1542-3565(04)00619-6 · Cited by 657 · see citing works
Khoruts, A., Dicksved, J., Jansson, J. K., & Sadowsky, M. J. (2010) · Journal of Clinical Gastroenterology · doi:10.1097/mcg.0b013e3181c87e02 · Cited by 649 · see citing works
Proton Pump Inhibitors Exacerbate NSAID-Induced Small Intestinal Injury by Inducing Dysbiosis
Wallace, J. L., Syer, S., Denou, E., de Palma, G., Vong, L., McKnight, W., Jury, J., Bolla, M., Bercik, P., Collins, S. M., et al. (2011) · Gastroenterology · doi:10.1053/j.gastro.2011.06.075 · Cited by 460 · see citing works
Proton Pump Inhibitor Use and the Risk of Small Intestinal Bacterial Overgrowth: A Meta-analysis
Lo, W., & Chan, W. W. (2013) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2012.12.011 · Cited by 353 · see citing works
Wong, V. W., Tse, C., Lam, T. T., Wong, G. L., Chim, A. M., Chu, C. W., Yeung, D. K., Law, P. T. W., Kwan, H. S., Yu, J. Q., et al. (2013) · PLoS ONE · doi:10.1371/journal.pone.0062885 · Cited by 342 · see citing works
Proton pump inhibitors as a risk factor for Clostridium difficile diarrhoea
Cunningham, R., Dale, B., Undy, B., & Gaunt, N. (2003) · Journal of Hospital Infection · doi:10.1016/s0195-6701(03)00088-4 · Cited by 331 · see citing works
Pouchitis: result of microbial imbalance?
Embden, J. G. R.-V., Schouten, W. R., & van Lieshout, L. M. (1994) · Gut · doi:10.1136/gut.35.5.658 · Cited by 255 · see citing works
Does the microbiota play a role in the pathogenesis of autoimmune diseases?
McLean, M. H., Dieguez, D., Miller, L. M., & Young, H. A. (2014) · Gut · doi:10.1136/gutjnl-2014-308514 · Cited by 207 · see citing works
From Stool Transplants to Next-Generation Microbiota Therapeutics
Petrof, E. O., & Khoruts, A. (2014) · Gastroenterology · doi:10.1053/j.gastro.2014.01.004 · Cited by 184 · see citing works
Tleyjeh, I. M., Abdulhak, A. A. B., Riaz, M. A., Alasmari, F. A., Garbati, M. A., Alghamdi, M. A. A., Khan, A. R., Al-Tannir, M. A., Erwin, P. J., Ibrahim, T., et al. (2012) · PLoS ONE · doi:10.1371/journal.pone.0050836 · Cited by 148 · see citing works
Fujimori, S., Seo, T., Gudis, K., Ehara, A., Kobayashi, T., Mitsui, K., Yonezawa, M., Tanaka, S., Tatsuguchi, A., & Sakamoto, C. (2009) · Gastrointestinal Endoscopy · doi:10.1016/j.gie.2008.08.017 · Cited by 127 · see citing works
Self-citationSpiegel, B. M. R., Chey, W. D., & Chang, L. (2008) · The American Journal of Gastroenterology · doi:10.1111/j.1572-0241.2008.01992.x · Cited by 95 · see citing works
The role of small intestinal bacterial overgrowth in postgastrectomy patients
Paik, C. N., Choi, M., Lim, C. H., et al. (2011) · Neurogastroenterology & Motility · doi:10.1111/j.1365-2982.2011.01686.x · Cited by 84 · see citing works
Lanas, Á., & Ferrández, Á. (2006) · Chinese Journal of Digestive Diseases · doi:10.1111/j.1443-9573.2006.00257.x · Cited by 34 · see citing works
Fujimori, S., Takahashi, Y. I., Seo, T., et al. (2010) · Digestion · doi:10.1159/000308361 · Cited by 22 · see citing works
Self-citationProteus dysbioses in patients with ulcerative colitis
Kanareykina, S. K., Misautova, A. A., Zlatkina, A. R., et al. (1987) · Food / Nahrung · doi:10.1002/food.19870310570 · Cited by 13 · see citing works
Clinical significance of changes of flora in the upper digestive tract
Knoke, M., & Bernhardt, H. (1989) · Infection · doi:10.1007/bf01639535 · Cited by 8 · see citing works
On the mechanism of cereobiogen readjustment to dysbiosis.
Bai, K. (1985) · PubMed · Cited by 4 · see citing works
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Proton pump inhibitors and dysbiosis: current knowledge and aspects to be clarified
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Gwee, K.-A., Goh, V., Lima, G., & Setia, S. (2018) · Journal of Pain Research · doi:10.2147/jpr.s156938 · Cited by 117 · see citing works
Anti-Acid Drug Treatment Induces Changes in the Gut Microbiome Composition of Hemodialysis Patients
Lin, Y.-T., Lin, T.-Y., Hung, S.-C., Liu, P.-Y., Wu, P.-H., Chuang, Y.-S., Hung, W.-C., Chiu, Y.-W., Kuo, M.-C., & Wu, C.-Y. (2021) · Microorganisms · doi:10.3390/microorganisms9020286 · Cited by 22 · see citing works
Schmulson, M. J., & Frati-Munari, A. C. (2019) · Revista de Gastroenterología de México · doi:10.1016/j.rgmx.2018.02.008 · Cited by 14 · see citing works
- Authors
- Fujimori, S.
- Affiliations
- Nippon Medical School (JP)
- Corresponding author
- Fujimori, Shunji
- ORCID
- Fujimori, Shunji
- Venue
- World Journal of Gastroenterology
- Publisher
- Baishideng Publishing Group Inc.
- Published
- 2015-06-14
- Volume
- 21
- Issue
- 22
- Pages
- 6817-6819
- ISSN
- 1007-9327 (ISSN-L)
- PMC
- PMC4462721
- OpenAlex
- W2179522331
- Cited by
- 70
- References
- 21
- Citations by year
- 2026: 2 · 2025: 5 · 2024: 8 · 2023: 4 · 2022: 6 · 2021: 9 · 2020: 2 · 2019: 7 · 2018: 10 · 2017: 11 · 2016: 4 · 2015: 2
- FWCI
- 3.91
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by-nc
- Locations
- World Journal of Gastroenterology (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Health Sciences › Medicine › Gastroenterology › Gastroesophageal reflux and treatments
- Keywords
- proton pump inhibitors, small intestine, small intestinal bacterial overgrowth, dysbiosis, gut microbiota, postgastrectomy, Clostridium difficile infection, acid suppression, probiotics, prebiotics, fecal microbiota transplantation, inflammatory bowel disease, diabetes mellitus, obesity, non-alcoholic fatty liver disease, autoimmune disease
- MeSH terms
- Animals, Anti-Inflammatory Agents, Non-Steroidal, Drug Interactions, Humans, Intestine, Small, Risk Factors, Proton Pump Inhibitors, Dysbiosis
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