Proton pump inhibitors decrease diversity in gut microbes, and increase the risk of complications
People who regularly take proton pump inhibitors (PPIs) have less diversity among their gut bacteria, putting them at increased risk for infections like clostridium difficile and pneumonia, in addition to vitamin deficiencies and bone fractures, a new study has shown.
Before reaching for that daily antacid, you might consider what it's doing to the trillions of bugs living in your gut. A new Mayo Clinic study in the open access journal Microbiome shows that people who regularly take proton pump inhibitors (PPIs) have less diversity among their gut bacteria, putting them at increased risk for infections like clostridium difficile and pneumonia, in addition to vitamin deficiencies and bone fractures.
"Evidence has been mounting for years that long-term use of proton pump inhibitors poses increased risks for a variety of associated complications, but we have never really understood why," says John DiBaise, M.D., a Mayo Clinic gastroenterologist and senior author on the study. "What this study does for the first time is demonstrate a plausible explanation for these associated conditions."
Many epidemiological studies have linked PPIs to nutritional, metabolic and infectious disorders, despite the class of drugs' long history of safety and efficacy. Specifically, their prolonged use has been associated with iron and vitamin B12 deficiencies, hypomagnesemia, osteoporosis-related fractures, small intestinal bacterial overgrowth, and community-acquired pneumonia. The Food and Drug Administration has issued several safety communications about use of high-dose PPIs (available through prescription) and long-term use at any dose, including over-the-counter medications.
Eat smaller portions at meals • Consume less fat • Avoid laying down for at least 2 hours after eating (avoid late-night snacks) • Wear loose fitting clothing • Elevate the head of the bed about 6 inches (this is best done by placing a block under the headboard, rather than stacking pillows) • Lose weight (as little as 2 to 5 Kg may help) • Avoid alcohol, tobacco and foods that trigger symptoms.
The above story is based on materials provided by Mayo Clinic. The original article was written by Sam Smith. Note: Materials edited for length.
Charlie T Seto, Patricio Jeraldo, Robert Orenstein, Nicholas Chia, John K DiBaise. Prolonged use of a proton pump inhibitor reduces microbial diversity: implications for Clostridium difficile susceptibility. Microbiome, 2014; 2 (1): 42 DOI: 10.1186/2049-2618-2-42
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