IMPACT OF PROTON PUMP INHIBITORS ON LONG-TERM GUT HEALTH.

Abstract

Background: Proton Pump Inhibitors (PPIs) are very popular in the treatment of gastrointestinal disorders caused by acid. Although it is effective, there is increasing evidence that its long-term use can adversely affect gut health by affecting the equilibrium of microbes, exposing the human body to infection risk, and disrupting nutrient absorption, which makes the question of its long-term safety questionable.

Objective: To assess the effects of the use of long-term PPI on gut microbiota, gastrointestinal symptoms, and complications in adult patients.

Methodology: this  cross-sectional study conducted at department of Gastroenterology MTI LRH Peshawar from jan 2021 to jan 2022. We split them into long-term PPI users (more than 12 months, n=50) and non-users (n=50). Adults aged 18–65 years were recruited, and those adults who had previous antibiotic intake or any chronic gastrointestinal disorder were excluded. Gastrointestinal symptoms data were collected using structured questionnaires, and microbiota diversity was analyzed in stool samples. The statistical analysis was done with the help of SPSS version 25, and the mean standard deviation has been computed, and a p-value of less than 0.05 was taken as significant.

Results: The mean age of participants was 42.6 ± 11.3 years, with 54% males. Gastrointestinal symptoms were significantly higher among PPI users, with bloating (68% vs. 32%, p=0.002) and diarrhea (40% vs. 18%, p=0.01). Reduced microbial diversity and decreased beneficial bacteria were observed in PPI users (p=0.003). SIBO was more prevalent in the PPI group (28% vs. 10%, p=0.02). Additionally, vitamin B12 deficiency (22% vs. 8%, p=0.04) and lower magnesium levels (1.7 ± 0.3 vs. 2.0 ± 0.2 mg/dL, p=0.01) were noted.

Conclusion: The use of PPI over a long period of time is related to serious negative impacts on gut health. The use of rational prescriptions and periodic monitoring is also necessary to reduce possible risks.