Bacterial overgrowth during treatment with omeprazole compared with cimetidine: a prospective randomised double blind study.

Thorens, J.; Froehlich, Florian; Schwizer, Werner; Saraga, E.; Billé, Jacques; Gyr, K.; Duroux, P; Nicolet, M.; Pignatelli, Brigitte; Blum, A. L.; Gonvers, J.-J.; Fried, Michael

doi:10.1136/gut.39.1.54

Cited by 300 publications

(215 citation statements)

References 46 publications

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“…In addition, 1 study showed that there was an increase in the incidence of colonization by the commensals from the colon to the relatively sterile upper GI tract in patients receiving PPIs. 11 This observation was confirmed by the results of a single study in which PPIs were associated with concurrent disease and incidence of diarrhea and nausea in renal transplant recipients. 12 Clostridium difficile-associated diarrhea was also reported with increased use of PPIs.…”

Section: Introductionsupporting

confidence: 73%

Untitled

Królikowski

Pawłowicz²,

Budzisz³

et al. 2016

Exp Clin Transplant

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Objectives: Although immunosuppressive drugs have been recognized as leading causes of gastrointestinal symptoms after kidney transplant, other widely used medications such as proton-pump inhibitors recently have been implicated. Our aim was to study the effects of chronic proton-pump inhibitor therapy on gastrointestinal symptoms in clinically stable patients late after kidney transplant. Materials and Methods:The study comprised 100 kidney transplant recipients (66 men and 34 women, mean age of 49 ± 12 y, mean time after transplant of 56 ± 46 mo). All patients completed the Gastrointestinal Symptoms Rating Scale and the Quality of Life Questionnaire SF-8 surveys. Results:The most commonly reported symptoms included borborygmus (27%), flatulence (23%), abdominal distension (18%), urgent need of defecation (17%), and heartburn, acid reflux, and eructation (13%). Proton-pump inhibitors were chronically used by 50% of patients and sporadically by 33%. Gastrointestinal Symptoms Rating Scale scores were higher in patients who used proton-pump inhibitors (mean score of 7.8 ± 5.5 vs 4.6 ± 3.0; P = .013). Total score of items representing diarrhea in the Gastrointestinal Symptoms Rating Scale (increased passage of stools, loose stools, urgent need of defecation, incomplete evacuation) was higher in patients treated with proton-pump inhibitors than in those not treated (2.3 ± 2.2 vs 1.3 ± 1.9; P = .04). Conclusions: Chronic use of proton-pump inhibitors may increase the prevalence of gastrointestinal symptoms, particularly diarrhea, in patients late after kidney transplant.

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Section: Introductionsupporting

confidence: 73%

Untitled

Królikowski

Pawłowicz²,

Budzisz³

et al. 2016

Exp Clin Transplant

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“…pylori infection might also affect the normal gastrointestinal flora as a result of the reduced gastric acid secretion induced by H. pylori-associated chronic gastritis, contributing to colorectal carcinogenesis (34). Previous studies have indicated that the presence of enteric infection and overgrowth of intestinal bacteria are directly related to a reduction in gastric acid secretion (35)(36)(37). Our previous study demonstrated that CAG-positive asymptomatic middle-aged subjects, as determined by the serum PG levels of PG I ≤70 ng/ml and a PG I/II ratio of ≤3.0, were found to have larger colonic microflora compared to CAG-negative subjects, with an increase in 83% of the genera or groups comprising intestinal microflora (6).…”

Section: Discussionmentioning

confidence: 99%

Elevated risk of recurrent colorectal neoplasia with Helicobacter pylori-associated chronic atrophic gastritis: A follow-up study of patients with endoscopically resected colorectal neoplasia

Inoue

Kato

Yoshimura

et al. 2012

Molecular and Clinical Oncology

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Abstract.In a previous population-based case-control study, we demonstrated an elevated risk of colorectal neoplasia with Helicobacter pylori (H. pylori) infection. The present study investigated the effects of H. pylori-associated chronic gastritis on the development of colorectal neoplasia by analyzing the recurrence of colorectal neoplasia subsequent to endoscopic resection. Ninety-nine patients who had undergone endoscopic resection of colorectal neoplasia were monitored under colonoscopy, and the recurrence of colorectal neoplasia was prospectively investigated. The stage of H. pylori-associated chronic gastritis in each subject was evaluated using a combination of two serum tests: H. pylori antibody and pepsinogen. In the present cohort, colorectal neoplasia recurred at a rate of 15,296/100,000 person-years during the study period. After adjusting for the confounding factors, chronic atrophic gastritis (CAG) was identified as an independent risk factor [adjusted hazard ratio (HR), 2.72; 95% confidence interval, 1.33-5.57], while H. pylori-infected non-atrophic gastritis was not identified as an independent risk factor for recurrent colorectal neoplasia. Colorectal neoplasia recurred earlier and was significantly more frequent in patients with CAG (22,573/100,000 person-years) compared to patients without CAG (11,089/100,000 person-years; P=0.029, log-rank test).Patients with more extensive CAG showed a higher risk of recurrence. These results demonstrated a significant elevation of the risk of recurrent colorectal neoplasia with the establishment and progression of CAG, indicating the involvement of H. pylori infection in the development of colorectal neoplasia. The two serum tests were useful clinical markers for noninvasively evaluating the risk of each individual for recurrent colorectal neoplasia subsequent to endoscopic resection.

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“…Gastric acid is an important barrier to colonization and infections by invading pathogens [31,32] . There may be an increased incidence of Clostridium difficile infections with PPI administration [12] .…”

Section: Diseasementioning

confidence: 99%

Proton pump inhibitor-associated pneumonia: Not a breath of fresh air after all?

Fohl

Regal²

2011

WJGPT

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Over the past two decades, proton pump inhibitors (PPIs) have emerged as highly effective and relatively safe agents for the treatment of a variety of gastrointestinal disorders. Unfortunately, this desirable pharmacological profile has also contributed to superfluous and widespread use in both the inpatient and outpatient settings. While generally well-tolerated, research published over the last decade has associated these agents

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Bacterial overgrowth during treatment with omeprazole compared with cimetidine: a prospective randomised double blind study.

Cited by 300 publications

References 46 publications

Untitled

Untitled

Elevated risk of recurrent colorectal neoplasia with Helicobacter pylori-associated chronic atrophic gastritis: A follow-up study of patients with endoscopically resected colorectal neoplasia

Proton pump inhibitor-associated pneumonia: Not a breath of fresh air after all?

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