title: The impact of proton pump inhibitors on the human gastrointestinal microbiome.
abstract: Potent gastric acid suppression using proton pump inhibitors (PPIs) is common in clinical practice but may have important effects on human health that are mediated through changes in the gastrointestinal microbiome. In the esophagus, PPIs change the normal bacterial milieu to decrease distal esophageal exposure to inflammatory gram-negative bacteria. In the stomach, PPIs alter the abundance and location of gastric Helicobacter pylori and other bacteria. In the small bowel, PPIs cause polymicrobial small bowel bacterial overgrowth and have been associated with the diagnosis of celiac disease. In the colon, PPIs associate with incident but not recurrent Clostridium difficile infection.
authors.affiliation: Division of Digestive and Liver Diseases, Columbia University Medical Center, 630 West 168th Street, New York, NY 10032, USA. Electronic address: def2004@cumc.columbia.edu.
authors.forename: Daniel E
authors.initials: DE
authors.lastname: Freedberg
authors.affiliation: Division of Digestive and Liver Diseases, Columbia University Medical Center, 630 West 168th Street, New York, NY 10032, USA; Celiac Disease Center at Columbia University, 180 Fort Washington Avenue, New York, NY 10032, USA.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Lebwohl
authors.affiliation: Division of Digestive and Liver Diseases, Columbia University Medical Center, 630 West 168th Street, New York, NY 10032, USA.
authors.forename: Julian A
authors.initials: JA
authors.lastname: Abrams
mesh_terms: D002446:Celiac Disease / Q000209:etiology* / Q000382:microbiology; D041981:Gastrointestinal Tract / Q000737:chemistry / Q000187:drug effects / Q000382:microbiology*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D064307:Microbiota / Q000187:drug effects*; D054328:Proton Pump Inhibitors / Q000009:adverse effects* / Q000737:chemistry / Q000627:therapeutic use
chemical_list: D054328:Proton Pump Inhibitors
keywords: Barrett's esophagus; Clostridium difficile infection; Gastric acid suppression; Helicobacter pylori; Human microbiome; Hypergastrinemia; Proton pump inhibitors; Small bowel bacterial overgrowth