PLoS ONE (Jan 2017)

Proton pump inhibitor therapy did not increase the prevalence of small-bowel injury: A propensity-matched analysis.

  • Atsuo Yamada,
  • Ryota Niikura,
  • Koutarou Maki,
  • Masanao Nakamura,
  • Hirotsugu Watabe,
  • Mitsuhiro Fujishiro,
  • Shiro Oka,
  • Shunji Fujimori,
  • Atsushi Nakajima,
  • Naoki Ohmiya,
  • Takayuki Matsumoto,
  • Shinji Tanaka,
  • Kazuhiko Koike,
  • Choitsu Sakamoto

DOI
https://doi.org/10.1371/journal.pone.0182586
Journal volume & issue
Vol. 12, no. 8
p. e0182586

Abstract

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Previous studies have reported that the suppression of acid secretion by using proton pump inhibitors (PPIs) results in dysbiosis of the small-bowel microbiota, leading to exacerbated small-bowel injuries, including erosions and ulcers. This study was designed to assess the association between PPI therapy and small-bowel lesions after adjustment for the differences in baseline characteristics between users and non-users of PPIs.We retrospectively studied patients suspected to be suffering from small-bowel diseases, who underwent capsule endoscopy between 2010 and 2013. We used propensity matching to adjust for the differences in baseline characteristics between users and non-users of PPIs. The outcomes included the prevalence of small-bowel lesions: erosion, ulcer, angioectasia, varices, and tumor.We selected 327 patient pairs for analysis after propensity matching, and found no significant differences in the prevalence of small-bowel injuries, including erosions and ulcers, between users and non-users of PPIs. Two subgroup analyses of the effect of the type of PPI and the effect of PPI therapy in users and non-users of nonsteroidal anti-inflammatory drugs indicated no significant differences in the prevalence of small-bowel injuries in these two groups.PPI therapy did not increase the prevalence of small-bowel injury, regardless of the type of PPI used and the use of nonsteroidal anti-inflammatory drugs.