The Gastric and Intestinal Microbiome: Role of Proton Pump Inhibitors

Purpose of review The discovery of Helicobacter pylori and other organisms colonizing the stomach and the intestines has shed some light on the importance of microbiome in maintaining overall health and developing pathological conditions when alterations in biodiversity are present. The gastric acid...

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Veröffentlicht in:Current gastroenterology reports 2017-08, Vol.19 (8), p.42-42, Article 42
Hauptverfasser: Minalyan, Artem, Gabrielyan, Lilit, Scott, David, Jacobs, Jonathan, Pisegna, Joseph R.
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container_end_page 42
container_issue 8
container_start_page 42
container_title Current gastroenterology reports
container_volume 19
creator Minalyan, Artem
Gabrielyan, Lilit
Scott, David
Jacobs, Jonathan
Pisegna, Joseph R.
description Purpose of review The discovery of Helicobacter pylori and other organisms colonizing the stomach and the intestines has shed some light on the importance of microbiome in maintaining overall health and developing pathological conditions when alterations in biodiversity are present. The gastric acidity plays a crucial role in filtering out bacteria and preventing development of enteric infections. In this article, we discuss the physiology of gastric acid secretion and bacterial contribution to the composition of gastric and intestinal barriers and review the current literature on the role of proton pump inhibitors (PPIs) in the microbial biodiversity of the gastrointestinal tract. Recent findings Culture-independent techniques, such as 16S rRNA sequencing, have revolutionized our understanding of the microbial biodiversity in the gastrointestinal tract. Luminal and mucosa-associated microbial populations are not identical. Streptococcus is overrepresented in the biopsies of patients with antral gastritis and may also be responsible for the development of peptic ulcer disease. The use of PPIs favors relative streptococcal abundance irrespective of H. pylori status and may explain the persistence of dyspeptic symptoms in patients on PPI therapy. Increased risk of enteric infections has also been seen in patients taking PPIs. The overuse of PPIs leads to significant shift of the gastrointestinal microbiome towards a less healthy state. Summary With the advent of PPIs, many studies have demonstrated the significant changes in the microbial composition of both gastric and intestinal microbiota. Although they are considered relatively safe over-the-counter medications, PPIs in many cases are over- and even inappropriately used. Future studies assessing the safety of PPIs and their role in the development of microbiome changes should be encouraged.
doi_str_mv 10.1007/s11894-017-0577-6
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Increased risk of enteric infections has also been seen in patients taking PPIs. The overuse of PPIs leads to significant shift of the gastrointestinal microbiome towards a less healthy state. Summary With the advent of PPIs, many studies have demonstrated the significant changes in the microbial composition of both gastric and intestinal microbiota. Although they are considered relatively safe over-the-counter medications, PPIs in many cases are over- and even inappropriately used. 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subjects Enzymes
Gastric Acid - metabolism
Gastritis - microbiology
Gastroenterology
Gastrointestinal Microbiome - drug effects
Helicobacter pylori
Histamine
Humans
Medicine
Medicine & Public Health
Nervous system
Peptic Ulcer - microbiology
Peptides
Physiology
Plasma
Proton Pump Inhibitors - adverse effects
Protons
RNA, Ribosomal, 16S - genetics
Section Editors
Stomach
Stomach and Duodenum (J Pisegna and J Benhammou
Streptococcus - pathogenicity
Topical Collection on Stomach and Duodenum
title The Gastric and Intestinal Microbiome: Role of Proton Pump Inhibitors
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