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Significant association between the use of different proton pump inhibitors and microscopic colitis: a nationwide

Ole K Bonderup1, Gunnar L Nielsen2,3, Michael Dall4,5

  • 1Diagnostic Centre, Regional Hospital Silkeborg, and University Research Clinic for Innovative Patient Pathways, Aarhus University, Aarhus, Denmark.

Alimentary Pharmacology & Therapeutics
|July 25, 2018
PubMed
Abstract

Insights

Proton pump inhibitor (PPI) use is strongly linked to microscopic colitis, particularly collagenous and lymphocytic types. Ongoing PPI use, especially lansoprazole, shows the highest risk for developing these conditions.

Area of Science:

  • Gastroenterology
  • Pharmacology

Background:

  • Microscopic colitis is characterized by chronic watery diarrhea.
  • Previous research suggests a link between proton pump inhibitor (PPI) use and microscopic colitis.

Purpose of the Study:

  • To investigate the association between PPI use and microscopic colitis.
  • To examine how timing, dosage, and specific PPIs influence this association.

Main Methods:

  • A case-control study involving 10,652 patients diagnosed with microscopic colitis over 10 years.
  • Utilized Danish Pathology and Prescription Registers for diagnosis and PPI use data.
  • Employed conditional logistic regression to calculate adjusted odds ratios (aOR).

Main Results:

  • Strong associations were found between current PPI use and both collagenous colitis (aOR 6.98) and lymphocytic colitis (aOR 3.95).
  • Lansoprazole showed the strongest association for both types (aOR 15.74 for collagenous, aOR 6.87 for lymphocytic).
  • The risk was highest with current PPI use, decreasing with recent or past use; no clear dose-response was observed.

Conclusions:

  • A significant association exists between ongoing proton pump inhibitor use and microscopic colitis.
  • Current PPI users, particularly those on lansoprazole, face an elevated risk.

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