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The effect of omeprazole treatment on the gut microflora and neutrophil function
Maja Kostrzewska1, Agnieszka Świdnicka-Siergiejko1, Dorota Olszańska2
1Department of gastroenterology and internal medicine, medical university of Bialystok, ul. Sklodowska-Curie 24A, 15-276 Bialystok, Poland.
Background And Aim:
Proton pump inhibitors (PPIs) may increase the risk of Clostridium difficile infections. There are interactions between gut microbiota and innate immune cells including neutrophils. We evaluated the effect of treatment with omeprazole on the gut microflora and neutrophil function.
Methods:
In 50 patients, we evaluated the effect of 4-week omeprazole treatment (n=25 with 20mg per day and n=25 with 20mg twice daily) on intragastric pH, results of stool culture and lactulose hydrogen breath test (LHBT) and neutrophil function.
Results:
The treatment caused significant increase of the mean intragastric pH, especially in the group with 20mg omeprazole twice daily (from 2.05±0.59 to 5.06±1.6, P<0.001). In LHBT, the increase of hydrogen concentration was observed in higher percentage of patients with 20mg of omeprazole twice daily, compared to patients with the lower dose (42.1% vs 29.4%; ns). Four weeks of omeprazole treatment have caused considerable changes in stool culture results. Patients treated with higher dose of omeprazole have had some tendency to decrease diversity of colonic microflora in comparison with patients treated with the lower dose of omeprazole. Treatment with omeprazole did not result in C. difficile positive stool culture and had no significant effect on neutrophil function.
Conclusions:
Omeprazole treatment have caused considerable changes in stool culture results. Patients treated with the higher dose had some tendency to decreased diversity of colonic microflora and towards changes in fermenting bacteria of the gut. The potential effect of omeprazole on gut microflora does not depend on neutrophil function deterioration.
Insights
Proton pump inhibitors like omeprazole alter gut bacteria diversity. This study found omeprazole changes stool cultures and gut microflora, but does not impact neutrophil function or increase Clostridium difficile risk.
Area of Science:
- Gastroenterology
- Microbiology
- Immunology
Background:
- Proton pump inhibitors (PPIs) are linked to increased Clostridium difficile infection risk.
- Gut microbiota and innate immune cells, including neutrophils, interact.
- The impact of PPIs on gut microflora and neutrophil function requires further investigation.
Purpose of the Study:
- To evaluate the effect of omeprazole treatment on gut microflora composition.
- To assess the impact of omeprazole on neutrophil function.
- To determine if omeprazole alters the risk of Clostridium difficile infections.
Main Methods:
- Fifty patients received 4-week omeprazole treatment (20mg daily or twice daily).
- Intragastric pH, stool cultures, lactulose hydrogen breath tests (LHBT), and neutrophil function were assessed.
- Changes in gut microflora diversity and hydrogen concentration were analyzed.
Main Results:
- Omeprazole significantly increased intragastric pH, particularly at higher doses.
- Changes in stool culture results and a tendency towards decreased colonic microflora diversity were observed with higher omeprazole doses.
- Omeprazole treatment did not lead to positive Clostridium difficile stool cultures or significantly affect neutrophil function.
Conclusions:
- Omeprazole treatment alters gut microflora composition, with higher doses potentially reducing diversity.
- Changes in gut microflora appear independent of neutrophil function.
- Omeprazole does not appear to increase the risk of Clostridium difficile infection based on this study.
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