The Gastric and Intestinal Microbiome: Role of Proton Pump Inhibitors
By: Minalyan A, Gabrielyan L, Scott D, Jacobs J, Pisegna JR.
Curr Gastroenterol Rep. 2017 Aug;19(8):42..
Summary: Gastric acidity plays a crucial role in filtering out bacteria and preventing development of enteric infections. In this article, the authors 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. 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. Although they are considered relatively safe OTC medications, PPIs in many cases are over- and even inappropriately used.