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Clin Lab Med. 2014 Dec;34(4):771-85. doi: 10.1016/j.cll.2014.08.008. Epub 2014 Sep 24.

The impact of proton pump inhibitors on the human gastrointestinal microbiome.

Author information

1
Division of Digestive and Liver Diseases, Columbia University Medical Center, 630 West 168th Street, New York, NY 10032, USA. Electronic address: def2004@cumc.columbia.edu.
2
Division of Digestive and Liver Diseases, Columbia University Medical Center, 630 West 168th Street, New York, NY 10032, USA; Celiac Disease Center at Columbia University, 180 Fort Washington Avenue, New York, NY 10032, USA.
3
Division of Digestive and Liver Diseases, Columbia University Medical Center, 630 West 168th Street, New York, NY 10032, USA.

Abstract

Potent gastric acid suppression using proton pump inhibitors (PPIs) is common in clinical practice but may have important effects on human health that are mediated through changes in the gastrointestinal microbiome. In the esophagus, PPIs change the normal bacterial milieu to decrease distal esophageal exposure to inflammatory gram-negative bacteria. In the stomach, PPIs alter the abundance and location of gastric Helicobacter pylori and other bacteria. In the small bowel, PPIs cause polymicrobial small bowel bacterial overgrowth and have been associated with the diagnosis of celiac disease. In the colon, PPIs associate with incident but not recurrent Clostridium difficile infection.

KEYWORDS:

Barrett's esophagus; Clostridium difficile infection; Gastric acid suppression; Helicobacter pylori; Human microbiome; Hypergastrinemia; Proton pump inhibitors; Small bowel bacterial overgrowth

PMID:
25439276
PMCID:
PMC4254461
DOI:
10.1016/j.cll.2014.08.008
[Indexed for MEDLINE]
Free PMC Article

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