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Current Gastroenterology Reports
Published in: Current Gastroenterology Reports 8/2017

01-08-2017 | Stomach and Duodenum (J Pisegna and J Benhammou, Section Editors)

The Gastric and Intestinal Microbiome: Role of Proton Pump Inhibitors

Authors: Artem Minalyan, Lilit Gabrielyan, David Scott, Jonathan Jacobs, Joseph R. Pisegna

Published in: Current Gastroenterology Reports | Issue 8/2017

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Abstract

Purpose of review

The discovery of Helicobacter pylori and other organisms colonizing the stomach and the intestines has shed some light on the importance of microbiome in maintaining overall health and developing pathological conditions when alterations in biodiversity are present. The gastric acidity plays a crucial role in filtering out bacteria and preventing development of enteric infections. In this article, we discuss the physiology of gastric acid secretion and bacterial contribution to the composition of gastric and intestinal barriers and review the current literature on the role of proton pump inhibitors (PPIs) in the microbial biodiversity of the gastrointestinal tract.

Recent findings

Culture-independent techniques, such as 16S rRNA sequencing, have revolutionized our understanding of the microbial biodiversity in the gastrointestinal tract. Luminal and mucosa-associated microbial populations are not identical. Streptococcus is overrepresented in the biopsies of patients with antral gastritis and may also be responsible for the development of peptic ulcer disease. The use of PPIs favors relative streptococcal abundance irrespective of H. pylori status and may explain the persistence of dyspeptic symptoms in patients on PPI therapy. Increased risk of enteric infections has also been seen in patients taking PPIs. The overuse of PPIs leads to significant shift of the gastrointestinal microbiome towards a less healthy state.

Summary

With the advent of PPIs, many studies have demonstrated the significant changes in the microbial composition of both gastric and intestinal microbiota. Although they are considered relatively safe over-the-counter medications, PPIs in many cases are over- and even inappropriately used. Future studies assessing the safety of PPIs and their role in the development of microbiome changes should be encouraged.
Literature
1.
2.
Zeng N, Athmann C, Kang T, et al. PACAP type I receptor activation regulates ECL cells and gastric acid secretion. J Clin Invest. 1999;104(10):1383–91.PubMedPubMedCentralCrossRef
3.
Yamaji N, Yokoo Y, Iwashita T, et al. Structural determination of two active compounds that bind to the muscarinic M3 receptor in beer. Alcohol Clin Exp Res. 2007;31:S9–S14.PubMedCrossRef
4.
Schubert ML, Makhlouf GM. Gastrin secretion induced by distention is mediated by gastric cholinergic and vasoactive intestinal peptide neurons in rats. Gastroenterology. 1993;104(3):834–9.PubMedCrossRef
5.
Orloff SL, Bunnett NW, Wong H, Walsh JH, Debas HT. Neural and hormonal mechanisms mediate the enterogastric reflex: a study in intestinal transplants in rats. Gastroenterology. 1991;101(3):734–42.PubMedCrossRef
6.
7.
8.
Schubert ML, Peura DA. Control of gastric acid secretion in health and disease. Gastroenterology. 2008;134(7):1842–60.PubMedCrossRef
9.
Takeuchi K, Endoh T, Hayashi S, Aihara T. Activation of muscarinic acetylcholine receptor subtype 4 is essential for cholinergic stimulation of gastric acid secretion: relation to D cell/somatostatin. Front Pharmacol. 2016;7:278.PubMedPubMedCentralCrossRef
10.
Frick C, Rettenberger AT, Lunz ML, Breer H. Complex morphology of gastrin-releasing G-cells in the antral region of the mouse stomach. Cell Tissue Res. 2016;366(2):301–10.PubMedCrossRef
11.
Bitziou E, Patel BA. Simultaneous detection of gastric acid and histamine release to unravel the regulation of acid secretion from the guinea pig stomach. Am J Physiol Gastrointest Liver Physiol. 2012;303(3):G396–403.PubMedCrossRef
12.
Vuyyuru L, Schubert ML. Histamine, acting via H3 receptors, inhibits somatostatin and stimulates acid secretion in isolated mouse stomach. Gastroenterology. 1997;113(5):1545–52.PubMedCrossRef
13.
Schubert ML, Hightower J, Makhlouf GM. Linkage between somatostatin and acid secretion: evidence from use of pertussis toxin. Am J Phys. 1989;256(2 Pt 1):G418–22.
14.
15.
16.
Shimizu K, Li P, Lee KY, Chang TM, Chey WY. The mechanism of inhibitory action of secretin on gastric acid secretion in conscious rats. J Physiol. 1995;488(Pt 2):501–8.PubMedPubMedCentralCrossRef
17.
Schmidt WE, Schenk S, Nustede R, Holst JJ, Folsch UR, Creutzfeldt W. Cholecystokinin is a negative regulator of gastric acid secretion and postprandial release of gastrin in humans. Gastroenterology. 1994;107(6):1610–20.PubMedCrossRef
18.
Konturek JW, Konturek SJ, Kwiecien N, et al. Leptin in the control of gastric secretion and gut hormones in humans infected with Helicobacter pylori. Scand J Gastroenterol. 2001;36(11):1148–54.PubMedCrossRef
19.
Shin JM, Munson K, Vagin O, Sachs G. The gastric HK-ATPase: structure, function, and inhibition. Pflugers Archiv. 2009;457(3):609–22.PubMedCrossRef
20.
21.
Hersey SJ, Sachs G. Gastric acid secretion. Physiol Rev. 1995;75(1):155–89.PubMed
22.
Fujii T, Fujita K, Takeguchi N, Sakai H. Function of K(+)-Cl(−) cotransporters in the acid secretory mechanism of gastric parietal cells. Biol Pharm Bull. 2011;34(6):810–2.PubMedCrossRef
23.
Fellenius E, Berglindh T, Sachs G, et al. Substituted benzimidazoles inhibit gastric acid secretion by blocking (H+ + K+) ATPase. Nature. 1981;290(5802):159–61.PubMedCrossRef
24.
Li H, Meng L, Liu F, Wei JF, Wang YQ. H+/K+-ATPase inhibitors: a patent review. Expert Opin Ther Pat. 2013;23(1):99–111.PubMedCrossRef
25.
Galmiche JP, Bruley Des Varannes S, Ducrotte P, et al. Tenatoprazole, a novel proton pump inhibitor with a prolonged plasma half-life: effects on intragastric pH and comparison with esomeprazole in healthy volunteers. Aliment Pharmacol Ther. 2004;19(6):655–62.PubMedCrossRef
26.
27.
Sachs G, Shin JM. The basis of differentiation of PPIs. Drugs Today (Barc). 2004;40(Suppl A):9–14.
28.
Shin JM, Sachs G. Restoration of acid secretion following treatment with proton pump inhibitors. Gastroenterology. 2002;123(5):1588–97.PubMedCrossRef
29.
Stedman CA, Barclay ML. Review article: comparison of the pharmacokinetics, acid suppression and efficacy of proton pump inhibitors. Aliment Pharmacol Ther. 2000;14(8):963–78.PubMedCrossRef
30.
Hatlebakk JG, Katz PO, Camacho-Lobato L, Castell DO. Proton pump inhibitors: better acid suppression when taken before a meal than without a meal. Aliment Pharmacol Ther. 2000;14(10):1267–72.PubMedCrossRef
31.
Katsube T, Adachi K, Kawamura A, et al. Helicobacter pylori infection influences nocturnal gastric acid breakthrough. Aliment Pharmacol Ther. 2000;14(8):1049–56.PubMedCrossRef
32.
Ishizaki T, Horai Y. Review article: cytochrome P450 and the metabolism of proton pump inhibitors—emphasis on rabeprazole. Aliment Pharmacol Ther. 1999;13(Suppl 3):27–36.PubMedCrossRef
33.
Abelo A, Andersson TB, Antonsson M, Naudot AK, Skanberg I, Weidolf L. Stereoselective metabolism of omeprazole by human cytochrome P450 enzymes. Drug Metab Dispos. 2000;28(8):966–72.PubMed
34.
Andersson T, Hassan-Alin M, Hasselgren G, Rohss K. Drug interaction studies with esomeprazole, the (S)-isomer of omeprazole. Clin Pharmacokinet. 2001;40(7):523–37.PubMedCrossRef
35.
Furuta T, Ohashi K, Kamata T, et al. Effect of genetic differences in omeprazole metabolism on cure rates for Helicobacter pylori infection and peptic ulcer. Ann Intern Med. 1998;129(12):1027–30.PubMedCrossRef
36.
Tang HL, Li Y, Hu YF, Xie HG, Zhai SD. Effects of CYP2C19 loss-of-function variants on the eradication of H. pylori infection in patients treated with proton pump inhibitor-based triple therapy regimens: a meta-analysis of randomized clinical trials. PloS One. 2013;8(4):e62162.PubMedPubMedCentralCrossRef
37.
Marshall BJ, Warren JR. Unidentified curved bacilli in the stomach of patients with gastritis and peptic ulceration. Lancet. 1984;1(8390):1311–5.PubMedCrossRef
38.
Brown LM. Helicobacter pylori: epidemiology and routes of transmission. Epidemiol Rev. 2000;22(2):283–97.PubMedCrossRef
39.
Eusebi LH, Zagari RM, Bazzoli F. Epidemiology of Helicobacter pylori infection. Helicobacter. 2014;19:1–5.PubMedCrossRef
40.
McJunkin B, Sissoko M, Levien J, Upchurch J, Ahmed A. Dramatic decline in prevalence of Helicobacter pylori and peptic ulcer disease in an endoscopy-referral population. Am J Med. 124(3):260–4.
41.
Segal I, Ally R, Mitchell H. Helicobacter pylori—an African perspective. QJM: Int J Med. 2001;94(10):561–5.CrossRef
42.
43.
van Duynhoven YT, de Jonge R. Transmission of Helicobacter pylori: a role for food? Bull World Health Organ. 2001;79(5):455–60.PubMedPubMedCentral
44.
Bik EM, Eckburg PB, Gill SR, et al. Molecular analysis of the bacterial microbiota in the human stomach. Proc Natl Acad Sci U S A. 2006;103(3):732–7.PubMedPubMedCentralCrossRef
45.
Blaser MJ. Helicobacter pylori: microbiology of a ‘slow’ bacterial infection. Trends Microbiol. 1993;1(7):255–60.PubMedCrossRef
46.
Stingl K, Altendorf K, Bakker EP. Acid survival of Helicobacter pylori: how does urease activity trigger cytoplasmic pH homeostasis? Trends Microbiol. 2002;10(2):70–4.PubMedCrossRef
47.
Kao C-Y, Sheu B-S, Wu J-J. Helicobacter pylori infection: an overview of bacterial virulence factors and pathogenesis. Biom J. 2016;39(1):14–23.
48.
49.
Bytzer P, Dahlerup JF, Eriksen JR, Jarbol DE, Rosenstock S, Wildt S. Diagnosis and treatment of Helicobacter pylori infection. Dan Med Bull. 2011;58(4):C4271.PubMed
50.
McColl KE, El-Omar E, Gillen D. Interactions between H. pylori infection, gastric acid secretion and anti-secretory therapy. Br Med Bull. 1998;54(1):121–38.PubMedCrossRef
51.
Chen XY, Liu WZ, Shi Y, Zhang DZ, Xiao SD, Tytgat GNJ. Helicobacter pylori associated gastric diseases and lymphoid tissue hyperplasia in gastric antral mucosa. J Clin Pathol. 2002;55(2):133–7.PubMedPubMedCentralCrossRef
52.
53.
Jaakkimainen RL, Boyle E, Tudiver F. Is Helicobacter pylori associated with non-ulcer dyspepsia and will eradication improve symptoms? A meta-analysis. BMJ. 1999;319(7216):1040–4.PubMedPubMedCentralCrossRef
54.
Kim SS, Ruiz VE, Carroll JD, Moss SF. Helicobacter pylori in the pathogenesis of gastric cancer and gastric lymphoma. Cancer Lett. 2011;305(2):228–38.PubMedCrossRef
55.
Gasbarrini A, Carloni E, Gasbarrini G, Chisholm SA. Helicobacter pylori and extragastric diseases—other Helicobacters. Helicobacter. 2004;9:57–66.PubMedCrossRef
56.
Shahabi S, Rasmi Y, Jazani NH, Hassan ZM. Protective effects of Helicobacter pylori against gastroesophageal reflux disease may be due to a neuroimmunological anti-inflammatory mechanism. Immunol Cell Biol. 2007;86(2):175–8.PubMedCrossRef
57.
Amedei A, Codolo G, Del Prete G, de Bernard M, D’Elios MM. The effect of Helicobacter pylori on asthma and allergy. J Asthma Allergy. 2010;3:139–47.PubMedPubMedCentral
58.
59.
Testerman TL, Morris J. Beyond the stomach: an updated view of Helicobacter pylori pathogenesis, diagnosis, and treatment. World J Gastroenterol: WJG. 2014;20(36):12781–808.PubMedPubMedCentralCrossRef
60.
Li C, Ha T, Ferguson DA Jr, et al. A newly developed PCR assay of H. pylori in gastric biopsy, saliva, and feces. Evidence of high prevalence of H. pylori in saliva supports oral transmission. Dig Dis Sci. 1996;41(11):2142–9.PubMedCrossRef
61.
Liu H, Rahman A, Semino-Mora C, Doi SQ, Dubois A. Specific and sensitive detection of H. pylori in biological specimens by real-time RT-PCR and in situ hybridization. PloS One. 2008;3(7):e2689.PubMedPubMedCentralCrossRef
62.
Bassis CM, Erb-Downward JR, Dickson RP, et al. Analysis of the upper respiratory tract microbiotas as the source of the lung and gastric microbiotas in healthy individuals. mBio. 2015;6(2):e00037.PubMedPubMedCentralCrossRef
63.
64.
Li X-X, Wong GL-H, To K-F, et al. Bacterial microbiota profiling in gastritis without Helicobacter pylori infection or non-steroidal anti-inflammatory drug use. PLoS One. 2009;4(11):e7985.PubMedPubMedCentralCrossRef
65.
• Khosravi Y, Dieye Y, Poh BH, et al. Culturable bacterial microbiota of the stomach of Helicobacter pylori positive and negative gastric disease patients. Sci World J. 2014;2014:610421. This study showed the correlation between Streptococcus and peptic ulcer disease. Burkholderia pseudomallei was also isolated from the gastric samples, suggesting geographical variations in the biodiversity of gastric microbiome.
66.
Aviles-Jimenez F, Vazquez-Jimenez F, Medrano-Guzman R, Mantilla A, Torres J. Stomach microbiota composition varies between patients with non-atrophic gastritis and patients with intestinal type of gastric cancer. Sci Rep. 2014;4:4202.PubMedPubMedCentralCrossRef
67.
Engstrand L, Lindberg M. Helicobacter pylori and the gastric microbiota. Best Pract Res Clin Gastroenterol. 2013;27(1):39–45.PubMedCrossRef
68.
Delgado S, Cabrera-Rubio R, Mira A, Suarez A, Mayo B. Microbiological survey of the human gastric ecosystem using culturing and pyrosequencing methods. Microb Ecol. 2013;65(3):763–72.PubMedCrossRef
69.
•• Rolig AS, Cech C, Ahler E, Carter JE, Ottemann KM. The degree of Helicobacter pylori-triggered inflammation is manipulated by preinfection host microbiota. Infect Immun. 2013;81(5):1382–9. The authors revealed that the clinical course and outcome of H. pylori disease are influenced by the host gastric bacterial composition. They suggested that gastric microbiome could be used as a diagnostic marker to predict the outcome of H. pylori infection. PubMedPubMedCentralCrossRef
70.
Delgado S, Leite AM, Ruas-Madiedo P, Mayo B. Probiotic and technological properties of Lactobacillus spp. strains from the human stomach in the search for potential candidates against gastric microbial dysbiosis. Front Microbiol. 2014;5:766.PubMed
71.
Khosravi Y, Dieye Y, Loke MF, Goh KL, Vadivelu J. Streptococcus mitis induces conversion of Helicobacter pylori to coccoid cells during co-culture in vitro. PLoS One. 2014;9(11):e112214.PubMedPubMedCentralCrossRef
72.
Andersson AF, Lindberg M, Jakobsson H, Backhed F, Nyren P, Engstrand L. Comparative analysis of human gut microbiota by barcoded pyrosequencing. PLoS One. 2008;3(7):e2836.PubMedPubMedCentralCrossRef
73.
Brawner KM, Kumar R, Serrano CA, et al. Helicobacter pylori infection is associated with an altered gastric microbiota in children. Mucosal Immunol. 2017;
74.
Llorca L, Perez-Perez G, Urruzuno P, et al. Characterization of the gastric microbiota in a pediatric population according to Helicobacter pylori status. Pediatr Infect Dis J. 2017;36(2):173–8.PubMedCrossRef
75.
Nardone G, Compare D. The human gastric microbiota: is it time to rethink the pathogenesis of stomach diseases? United European Gastroenterol J. 2015;3(3):255–60.PubMedPubMedCentralCrossRef
76.
Mauch F, Bode G, Malfertheiner P. Identification and characterization of an ATPase system of Helicobacter pylori and the effect of proton pump inhibitors. Am J Gastroenterol. 1993;88(10):1801–2.PubMed
77.
Stoschus B, Dominguez-Munoz JE, Kalhori N, Sauerbruch T, Malfertheiner P. Effect of omeprazole on Helicobacter pylori urease activity in vivo. Eur J Gastroenterol Hepatol. 1996;8(8):811–3.PubMed
78.
Vesper BJ, Jawdi A, Altman KW, Haines GK 3rd, Tao L, Radosevich JA. The effect of proton pump inhibitors on the human microbiota. Curr Drug Metab. 2009;10(1):84–9.PubMedCrossRef
79.
Sanduleanu S, Jonkers D, De Bruine A, Hameeteman W, Stockbrugger RW. Non-Helicobacter pylori bacterial flora during acid-suppressive therapy: differential findings in gastric juice and gastric mucosa. Aliment Pharmacol Ther. 2001;15(3):379–88.PubMedCrossRef
80.
•• Paroni Sterbini F, Palladini A, Masucci L, et al. Effects of proton pump inhibitors on the gastric mucosa-associated microbiota in dyspeptic patients. Appl Environm Microbiol. 2016;82(22):6633–44. Firmicutes , particularly the Streptococcus genus, were found in a relative abundance in patients taking PPIs. The authors suggested that it may explain the exacerbation and persistence of dyspeptic symptoms in patients on PPI therapy. CrossRef
81.
Ley RE, Peterson DA, Gordon JI. Ecological and evolutionary forces shaping microbial diversity in the human intestine. Cell. 2006;124(4):837–48.PubMedCrossRef
82.
Mandar R, Mikelsaar M. Transmission of mother’s microflora to the newborn at birth. Biol Neonate. 1996;69(1):30–5.PubMedCrossRef
83.
84.
Yatsunenko T, Rey FE, Manary MJ, et al. Human gut microbiome viewed across age and geography. Nature. 2012;486(7402):222–7.PubMedPubMedCentral
85.
86.
Simrén M, Barbara G, Flint HJ, et al. Intestinal microbiota in functional bowel disorders: a Rome foundation report. Gut. 2013;62(1):159–76.PubMedCrossRef
87.
88.
Dukowicz AC, Lacy BE, Levine GM. Small intestinal bacterial overgrowth: a comprehensive review. Gastroenterol Hepatol. 2007;3(2):112–22.
89.
Swidsinski A, Loening-Baucke V, Lochs H, Hale LP. Spatial organization of bacterial flora in normal and inflamed intestine: a fluorescence in situ hybridization study in mice. World J Gastroenterol. 2005;11(8):1131–40.PubMedPubMedCentralCrossRef
90.
91.
Kahrstrom CT, Pariente N, Weiss U. Intestinal microbiota in health and disease. Nature. 2016;535(7610):47–7.
92.
Sekirov I, Russell SL, Antunes LCM, Finlay BB. Gut microbiota in health and disease. Physiol Rev. 2010;90(3):859–904.PubMedCrossRef
93.
94.
Smith P, Willemsen D, Popkes ML, et al. Regulation of life span by the gut microbiota in the short-lived African turquoise killifish. bioRxiv. 2017;
95.
96.
Salonen A, de Vos WM, Palva A. Gastrointestinal microbiota in irritable bowel syndrome: present state and perspectives. Microbiology. 2010;156(Pt 11):3205–15.PubMedCrossRef
97.
Vogtmann E, Hua X, Zeller G, et al. Colorectal cancer and the human gut microbiome: reproducibility with whole-genome shotgun sequencing. PLoS One. 2016;11(5):e0155362.PubMedPubMedCentralCrossRef
98.
De Palma G, Nadal I, Medina M, et al. Intestinal dysbiosis and reduced immunoglobulin-coated bacteria associated with coeliac disease in children. BMC Microbiol. 2010;10:63.PubMedPubMedCentralCrossRef
99.
100.
Fujimura KE, Lynch SV. Microbiota in allergy and asthma and the emerging relationship with the gut microbiome. Cell Host Microbe. 2015;17(5):592–602.PubMedPubMedCentralCrossRef
101.
Petra AI, Panagiotidou S, Hatziagelaki E, Stewart JM, Conti P, Theoharides TC. Gut-microbiota-brain axis and effect on neuropsychiatric disorders with suspected immune dysregulation. Clin Ther. 2015;37(5):984–95.PubMedPubMedCentralCrossRef
102.
Lutgendorff F, Akkermans LM, Soderholm JD. The role of microbiota and probiotics in stress-induced gastro-intestinal damage. Curr Mol Med. 2008;8(4):282–98.PubMedCrossRef
103.
Cario E, Gerken G, Podolsky DK. Toll-like receptor 2 controls mucosal inflammation by regulating epithelial barrier function. Gastroenterology. 2007;132(4):1359–74.PubMedCrossRef
104.
Stappenbeck TS, Hooper LV, Gordon JI. Developmental regulation of intestinal angiogenesis by indigenous microbes via Paneth cells. Proc Natl Acad Sci U S A. 2002;99(24):15451–5.PubMedPubMedCentralCrossRef
105.
Gordon HA, Bruckner-Kardoss E. Effect of normal microbial flora on intestinal surface area. Am J Phys. 1961;201:175–8.
106.
Wostmann B, Bruckner-Kardoss E. Development of cecal distention in germ-free baby rats. Am J Phys. 1959;197:1345–6.
107.
Husebye E, Hellstrom PM, Midtvedt T. Intestinal microflora stimulates myoelectric activity of rat small intestine by promoting cyclic initiation and aboral propagation of migrating myoelectric complex. Dig Dis Sci. 1994;39(5):946–56.PubMedCrossRef
108.
Alam M, Midtvedt T, Uribe A. Differential cell kinetics in the ileum and colon of germfree rats. Scand J Gastroenterol. 1994;29(5):445–51.PubMedCrossRef
109.
Hooper LV, Gordon JI. Commensal host-bacterial relationships in the gut. Science. 2001;292(5519):1115–8.PubMedCrossRef
110.
Beasley DE, Koltz AM, Lambert JE, Fierer N, Dunn RR. The evolution of stomach acidity and its relevance to the human microbiome. PLoS One. 2015;10(7):e0134116.PubMedPubMedCentralCrossRef
111.
Roggenbuck M, Baerholm Schnell I, Blom N, et al. The microbiome of new world vultures. Nat Commun. 2014;5:5498.PubMedCrossRef
112.
Lange K, Buerger M, Stallmach A, Bruns T. Effects of antibiotics on gut microbiota. Dig Dis. 2016;34(3):260–8.PubMedCrossRef
113.
114.
Russell TL, Berardi RR, Barnett JL, et al. Upper gastrointestinal pH in seventy-nine healthy, elderly, North American men and women. Pharm Res. 1993;10(2):187–96.PubMedCrossRef
115.
Loo VG, Bourgault AM, Poirier L, et al. Host and pathogen factors for Clostridium difficile infection and colonization. N Engl J Med. 2011;365(18):1693–703.PubMedCrossRef
116.
117.
Shin CM, Kim N, Kim YS, et al. Impact of long-term proton pump inhibitor therapy on gut microbiota in F344 rats: pilot study. Gut Liver. 2016;10(6):896–901.PubMedPubMedCentralCrossRef
118.
Leonard J, Marshall JK, Moayyedi P. Systematic review of the risk of enteric infection in patients taking acid suppression. Am J Gastroenterol. 2007;102(9):2047–56. quiz 2057PubMedCrossRef
119.
Dial MS. Proton pump inhibitor use and enteric infections. Am J Gastroenterol. 2009;104(Suppl 2):S10–6.PubMedCrossRef
120.
•• Jackson MA, Goodrich JK, Maxan M-E, et al. Proton pump inhibitors alter the composition of the gut microbiota. Gut. 2016;65(5):749–56. It is a large study (1827 healthy twins) that showed negative correlation between PPI use and microbial diversity of the gut. Also, overrepresentation of the upper gastrointestinal tract bacteria in the lower parts of the gut was detected. PubMedCrossRef
121.
Freedberg DE, Toussaint NC, Chen SP, et al. Proton pump inhibitors alter specific taxa in the human gastrointestinal microbiome: a crossover trial. Gastroenterology. 2015;149(4):883–5. e889PubMedPubMedCentralCrossRef
122.
•• Imhann F, Bonder MJ, Vich Vila A, et al. Proton pump inhibitors affect the gut microbiome. Gut. 2016;65(5):740–8. The findings of this European study involving both healthy subjects and patients with GI disease (1815 participants) supported the idea that PPI use is associated with the development of less healthy gut microbiome. Of note, a significant increase in pathogenic bacteria has been revealed. PubMedCrossRef
123.
Lo WK, Chan WW. Proton pump inhibitor use and the risk of small intestinal bacterial overgrowth: a meta-analysis. Clin Gastroenterol Hepatol. 2013;11(5):483–90.PubMedCrossRef
124.
Fujimori S. What are the effects of proton pump inhibitors on the small intestine? World J Gastroenterol: WJG. 2015;21(22):6817–9.PubMedPubMedCentral
125.
Lué A, Lanas A. Protons pump inhibitor treatment and lower gastrointestinal bleeding: balancing risks and benefits. World J Gastroenterol. 2016;22(48):10477–81.PubMedPubMedCentralCrossRef
126.
Gallo A, Passaro G, Gasbarrini A, Landolfi R, Montalto M. Modulation of microbiota as treatment for intestinal inflammatory disorders: an uptodate. World J Gastroenterol. 2016;22(32):7186–202.PubMedPubMedCentralCrossRef
Metadata
Title
The Gastric and Intestinal Microbiome: Role of Proton Pump Inhibitors
Authors
Artem Minalyan
Lilit Gabrielyan
David Scott
Jonathan Jacobs
Joseph R. Pisegna
Publication date
01-08-2017
Publisher
Springer US
Published in
Current Gastroenterology Reports / Issue 8/2017
Print ISSN: 1522-8037
Electronic ISSN: 1534-312X
DOI
https://doi.org/10.1007/s11894-017-0577-6

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WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

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