PPI drugs
Proton pump inhibitors or PPIs (omeprazole or Prilosec, Nexium, Prevacid, Aciphex, Protonix, Dexilant etc.) are acid blocking drugs used for heartburn, acid reflux and ulcers etc. Studies suggest they are frequently overused/overprescribed as some have argued, prescribed like a candy. Often for years! But are they really that benign to be used like a candy? Actually, the risks of PPIs keep piling up.
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The mechanism of PPIs involve suppressing stomach acid which considered to be part of body’s defenses against especially since PPI use increases risk of GI infections including C. difficile infection
Some studies show that PPI use alters the intestinal bacterial patterns or microbiota.
Effect of PPI Drugs on Microbiome
Studies by Jackson and colleagues and Imhann et al. examined the gut microbiome in 1827 healthy identical twins, one of whom was on PPI medications.
These investigators found that there is a significant decrease in normal lower gut bacteria when subjects take PPI drugs. At the same time, there is an increase in normal inhabitants of upper gut, more specifically increase in Streptococcaceae.
Same changes were seen in monozygotic twins given PPIs.
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Conclusions of PPI studies
Authors suggested that these alterations occur due to absence of acid between upper gut bacteria and the lower gut. This significant impact warrants caution against over use of these drugs.
Another study has shown that PPIs cause “an increase in bacterial genes involved in bacterial invasion” in the gut.
Effect of Aspirin-Like Drugs on Microbiome
Rogers and colleagues examined the effect of non-steroidal antiinflammatory drugs or NSAIDs (aspirin, ibuprofen like drugs) on microbiome. They found that aspirin users had more of Four OTUs (Prevotella species, Bacteroides species, family Ruminococcaceae, and Barnesiella species) as compared to those not taking aspirin. There were differences among different NSAID drugs also.
Combining NSAID with PPIs brought out even more different impact. Bacteroides species and Erysipelotrichaceae species were more seen in subjects using NSAIDs plus proton-pump inhibitors from those using NSAIDs alone.
Wall Street Journal Best Seller Dr. M's Seven-X Plan for Digestive Health
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