Passing the “Acid Test”: Do Proton Pump Inhibitors Affect the Composition of the Microbiome?

Excerpt

With the rising prevalence of gastroesophageal reflux disease (GERD) and other acid-peptic diseases, proton pump inhibitors (PPIs) are among the top 10 most commonly used medication worldwide [1]. While PPI use is of considerable value in the treatment of Helicobacter pylori infection and peptic ulcer disease, in recent years, chronic PPI use has also been linked to C. difficile infection, small intestinal bacterial overgrowth, and alterations of the intestinal microbiome [2]. The gut microbiome has been considered to be important for the maintenance of gut homeostasis and may even protect against infection with enteric organisms [3]. Though antibiotics are the most common drug class associated with gut microbial community shifts, there has been an increasing level of evidence that links nonantibiotic drugs to microbiome changes [4]. For this reason, there have been many studies of late examining the effect of PPI use on the composition of the gut microbiome. …