Proton pump inhibitor use is associated with elevated faecal calprotectin levels. A cross-sectional study on subjects referred for colonoscopy

Abstract

Objectives: Faecal Calprotectin (FC) is a sensitive marker for gut inflammation. However, slightly elevated FC levels are also common in subjects without inflammation. We investigated the association between FC and clinical factors including concomitant use of medical therapy in patients with a normal colonoscopy. Material and methods: Outpatients (n ¼ 1263) referred for colonoscopy, performed FC test (CALPRO) the day before the start of bowel preparation. All subjects answered questionnaires that included questions on the present and past health history, concomitant medical treatment and gastrointestinal symptoms (GSRS). A medical record chart review was performed to check for concomitant disease, cause of referral and the result of the colonoscopy including biopsies. Inclusion criteria were a normal colonoscopy. Exclusion criteria were inflammatory bowel disease, colon cancer and highgrade dysplasia. Results: Five hundred ninety subjects fulfilled the inclusion criteria and completed the study. Thirty-six per cent of the subjects had a FC >50 mg/g. In a logistic regression analysis, age (adjusted OR: 1.051; CI: 1.032-1.071), and the use of proton pump inhibitors (adjusted OR: 3.843; CI: 2.338-6.316), non-steroid anti-inflammatory drugs (adjusted OR: 2.411; CI: 1.162-5.002) and acetylsalicylic acid (adjusted OR: 2.934; CI: 1.085-3.448) were significantly associated with an elevated FC (>50 mg/g). Conclusions: More than one-third of the patients with a normal colonoscopy performed in clinical routine had a slightly elevated FC level. Our results emphasise the need for attention to age, the use of proton pump inhibitors, non-steroid anti-inflammatory drugs and acetylsalicylic acid in the interpretation of FC tests in clinical practice.

Dysbiosis, gut barrier dysfunction and inflammation in dementia: a pilot study

“…We found that PPI use was associated with increased intestinal inflammation. This has been previously described in the context of other diseases [65][66][67] and we have recently linked dysbiosis, gut permeability and intestinal inflammation to adverse outcome in patients with liver cirrhosis who use PPI [63]. Antihypertensive use was associated with slightly, but significantly elevated CRP levels, which is most likely due to the underlying disease and not to the drug itself, since arterial hypertension is associated with elevated CRP levels [68] and therefore validates the relevance of our findings although sample size is small.…”

Dysbiosis in dementia is associated with gut barrier dysfunction and linked to malnutrition and prescription drug use

“…We found that PPI use was associated with increased intestinal inflammation. This has been previously described [51][52][53] in other diseases and we have linked dysbiosis, gut permeability and intestinal inflammation to adverse outcome in patients with liver cirrhosis. [54] Antihypertensive use was associated with slightly, but significantly elevated CRP levels, which is most likely due to the underlying disease and not to the drug itself, since arterial hypertension is associated with elevated CRP levels [55] and therefore validates the relevance of our findings although sample size is small.…”

Dysbiosis, gut barrier dysfunction and inflammation in dementia: A pilot study

“…We found that PPI use was associated with increased intestinal in ammation. This has been previously described in the context of other diseases [65][66][67] and we have recently linked dysbiosis, gut permeability and intestinal in ammation to adverse outcome in patients with liver cirrhosis who use PPI. [63] Antihypertensive use was associated with slightly, but signi cantly elevated CRP levels, which is most likely due to the underlying disease and not to the drug itself, since arterial hypertension is associated with elevated CRP levels [68] and therefore validates the relevance of our ndings although sample size is small.…”