Proton Pump Inhibitors (PPIs) Impact Gut Health by Translocating Oral Microbiota
Nikhil Prasad Fact checked by:Thailand Medical News Team Oct 09, 2024 2 months, 1 week, 6 days, 3 hours ago
Med News: The Growing Use of PPIs and Emerging Concerns
Proton pump inhibitors (PPIs) have been a go-to treatment for reducing stomach acid since the 1980s. Commonly used to manage conditions such as gastroesophageal reflux disease (GERD), ulcers, and functional dyspepsia, these medications are widely prescribed. In fact, a quarter of the adult population is on PPIs, but up to 70% of prescriptions are deemed inappropriate. This
Med News report sheds light on the hidden risks tied to the overuse of PPIs, especially in altering the gut microbiota and possibly leading to more serious digestive complications.
Proton Pump Inhibitors (PPIs) Impact Gut Health by Translocating Oral Microbiota
Thailand Medical News has for some time been warning about the many dangers associated with Proton pump inhibitors (PPIs) usage:
https://www.thailandmedical.news/news/acid-reflux-medications-and-proton-pump-inhibitors-(ppis)-linked-to--kidney-disease
https://www.thailandmedical.news/news/new-study-links-ppis-to-kidney-disease-and-failure
https://www.thailandmedical.news/news/as-evidence-of-damage-from-long-term-ppi-use-mounts,-thai-medical-providers-should-rethink-strategies-to-treat-acid-reflux
https://www.thailandmedical.news/news/more-studies-emerging-that-ppis-(proton-pump-inhibitors)-linked-to-increased-risks-of-deaths
https://www.thailandmedical.news/news/more-bad-news-for-users-of-proton-pump-inhibitors-(ppis),-as-these-gastric-reflux-drugs-are-implicated-in-cholangitis
https://www.thailandmedical.news/news/how-low-can-some-american-doctors-get,-prescribing-ppis-to-babies-and-young-children
https://www.thailandmedical.news/news/study-finds-another-negative-side-effect-of-ppi-usage,-this-time-linked-to-increased-risk-of-acute-gastroenteritis
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https://www.thailandmedical.news/news/proton-pump-inhibitors-(ppis)-and-antibiotics-linked-to-increased-infectious-diarrhea-in-children
https://www.thailandmedical.news/news/ppis-or-acid-reflux-drugs-affects-cognitive-abilities-of-breast-cancer-survivors
https://www.thailandmedical.news/news/breaking-news-covid-19-alert-research-led-by-cedars-sinai-indicates-that-proton-pump-inhibitors-ppis-use-is-linked-to-increased-risk-of-covid-19
https://www.thailandmedical.news/news/proton-pump-inhibitors-ppis-increases-risk-of-fatty-liver-disease-by-disrupting-gut-microbiome-balance-according-to-korean-study
https://www.thailandmedical.news/news/covid-19-warning-malaysian-led-research-shows-that-gastric-reflux-drugs-ppis-linked-to-increased-risk-of-severe-or-fatal-covid-19-outcome
https://www.thailandmedical.news/news/health-news-university-of-minnesota-study-finds-that-long-term-use-of-ppis-for-gastric-reflux-linked-to-higher-risk-of-developing-dementia
https://www.thailandmedical.news/news/usage-of-proton-pump-inhibitors-associated-with-higher-risk-of-susceptibility-to-influenza-pneumonia-and-covid-19
One of the major issues scientists are now exploring is how PPIs can cause a shift in the balance of bacteria living in our digestive systems. PPIs can promote the migration of bacteria from the mouth to the gut, which can lead to harmful effects. A new study discusses the latest findings that shows how PPIs might affect oral and gut microbiota, potentially leading to digestive health problems.
PPIs and the Role of Gut and Oral Microbiota
Our digestive tract harbors an incredibly diverse microbial community, from the mouth to the gut. The idea that oral bacteria might enter the gut has been gaining scientific attention recently. Normally, stomach acid kills bacteria from the mouth before they reach the intestines. However, PPIs reduce stomach acidity, allowing bacteria that typically stay in the mouth to make their way down into the gut.
Studies have shown that PPIs disturb the delicate balance of gut microbiota, which can increase the risk of developing digestive disorders like inflammatory bowel disease (IBD) and Clostridioides difficile infection (CDI). Interestingly, it’s not just gut bacteria that change - oral bacteria such as Streptococcus, Rothia, and others are now found in the guts of PPI users.
New Research Sheds Light on Oral - Gut Bacterial Migration
Researchers from the Sichuan University - University of Oxford Huaxi Joint Centre for Gastrointestinal Cancer in China have recently discovered how PPI use leads to the migration of oral bacteria to the gut. A key study was conducted by Dr Xian Zhang, Dr Qing Li, Dr Siyuan Xia, Dr Yan He, Dr Yuqiang Liu, Dr Jinlin Yang, and Dr Xue Xiao, focusing on this oral - gut microbial axis. Their work uncovered that a seven-day course of esomeprazole (a type of PPI) could lead to a significant increase in the abundance of oral bacteria such as Streptococcus in the gut. This migration disrupts the gut’s natural environment, which could trigger digestive diseases.
The study also found that using mouthwash could reduce the migration of oral bacteria, suggesting that preventing oral bacteria from reaching the gut might mitigate some of the negative effects of PPIs.
What Happens to the Gut When Oral Microbes Take Over?
When oral bacteria enter the gut, they can cause a number of health problems. Studies have shown that people using PPIs often have an increased presence of certain harmful bacteria in their intestines, such as those that can lead to infections, gut inflammation, and other complications.
For example, the introduction of Streptococcus into the gut can increase the risk of conditions such as inflammatory bowel disease (IBD), enteric infections, and even colorectal cancer. Normally, the acidic environment in the stomach keeps oral bacteria in check, but PPIs reduce this defense mechanism.
This disturbance to the gut microbiome can weaken the gut's ability to fight off infections. One study showed that the use of PPIs significantly increased the presence of harmful bacteria like Clostridioides difficile, a notorious cause of antibiotic-resistant infections in hospitals.
Clinical Implications: Should We Be Concerned About PPI Overuse?
While PPIs are effective in managing acid-related disorders, their overuse might have long-term consequences. The growing body of research suggests that changes in gut microbiota due to PPI use could lead to an increased risk of digestive diseases, including gastrointestinal infections, liver disease, and certain types of cancers. Patients using PPIs for extended periods should be monitored for potential side effects, especially if they exhibit symptoms of digestive discomfort or infections.
Further investigation into the specific strains of bacteria linked to these conditions could lead to targeted therapies. There is already ongoing research into developing probiotic treatments that could restore the balance of gut bacteria in PPI users.
Future Directions for Research and Clinical Practice
The findings of this study suggest a need for new approaches to manage acid-related conditions. Instead of long-term reliance on PPIs, healthcare providers could explore alternative treatments, such as lifestyle changes, to reduce the need for acid-suppressing medications.
Additionally, more research is required to fully understand how the migration of oral bacteria into the gut contributes to specific digestive diseases. Understanding the exact pathways of this bacterial migration could lead to more precise treatments that prevent harmful bacteria from colonizing the gut.
Conclusion: The Bigger Picture
Proton pump inhibitors, while highly effective, are linked to significant changes in gut health due to their impact on oral and gut microbiota. The translocation of bacteria from the mouth to the intestines is a serious issue that could contribute to digestive diseases. As we continue to learn more about the complex interactions between the gut and oral microbiota, it’s becoming clear that careful use of PPIs is essential to avoid unintended health consequences. For patients using these drugs long-term, regular check-ups and potential alternative treatments should be considered.
The study findings were published in the peer-reviewed journal: Biomedicines.
https://www.mdpi.com/2227-9059/12/10/2271
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