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Association between chronic use of proton pump inhibitors and small- intestinal bacterial overgrowth assessed using

Yasuhiro Fujiwara, Toshio Watanabe, Motoko Muraki

    Hepato-Gastroenterology
    |April 29, 2015
    PubMed
    Abstract

    Insights

    Proton pump inhibitor (PPI) use is not linked to small intestinal bacterial overgrowth (SIBO) in Japanese patients. Postprandial fullness in PPI users may stem from causes other than SIBO.

    Area of Science:

    • Gastroenterology
    • Microbiology

    Background:

    • Proton pump inhibitors (PPIs) are widely used but linked to adverse events.
    • The association between PPI use and small intestinal bacterial overgrowth (SIBO) remains controversial.
    • Gastric acid suppression is a potential risk factor for SIBO.

    Purpose of the Study:

    • To investigate the prevalence of SIBO in Japanese patients using the lactulose hydrogen breath test (LHBT).
    • To assess the association between PPI use and SIBO.
    • To explore potential causes of postprandial fullness in PPI users.

    Main Methods:

    • Retrospective analysis of 94 Japanese patients undergoing LHBT.
    • Categorization into PPI users, histamine-2 receptor antagonist (H2RA) users, and controls.
    • Analysis of LHBT results and correlation with gastric acid-suppressive drug use.

    Main Results:

    • No significant difference in SIBO prevalence was found among PPI users, H2RA users, and controls.
    • Multiple-adjusted regression analysis revealed no significant association between PPI use and SIBO.
    • High prevalence of postprandial fullness in PPI users was observed, but not directly related to SIBO.

    Conclusions:

    • PPI treatment is not associated with SIBO in the studied Japanese population.
    • Alternative mechanisms, not SIBO, likely explain postprandial fullness in PPI users.
    • Further research is needed to elucidate the causes of gastrointestinal symptoms in PPI users.

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