Heartburn pills may help grow infection-causing bacteria in gut

Thu Jan 7, 2016 3:27pm EST
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By Lisa Rapaport

Popular heartburn pills known as proton pump inhibitors (PPIs) may be making some people more prone to bacterial infections by altering the types of bugs that grow in the gut, a U.K. study of twins suggests.

These pills work by stopping cells in the stomach lining from producing too much acid, which can prevent ulcers from forming and reduce reflux symptoms such as heartburn. The trouble is the drugs are also linked to an increased risk of bacterial infections such as pneumonia, which damages the lungs, and Clostridium difficile, which causes severe diarrhea.

Looking for clues to how PPIs might lead to infections, researchers compared stool samples from more than 1,800 British twins. When only one twin used PPIs, their fecal analysis turned up much more Streptococcaceae, a family of bacteria that includes Streptococcus and Lactococcus strains, and that typically inhabits the mouth and skin. Their increased numbers potentially make certain infections more likely, the researchers conclude in the journal Gut.

“By reducing the natural barrier of stomach acid, PPIs appear to let more bacteria from the skin, nose and mouth into the gut – and this can be detected in the stool samples,” senior study author Dr. Claire Steves of Kings College London said by email.

Because millions of people worldwide take PPIs, which are available without a prescription in Europe and the U.S., it’s crucial to understand how infections might unfold in the gut and be cautious to avoid over-use of the medicines, Steves added.

The drugs are generally safe, and very effective for treating ulcers and inflammation caused by excessive stomach acid, and the benefit of PPIs for these patients would outweigh the risk of harms posed by infections, Steves said.

But many patients who take PPIs for minor, temporary digestive discomfort don’t need them, and many people also remain on the pills much longer than necessary, Steves said.

“This study may play a part in reducing this unnecessary use, by providing the mechanism of the slight increase in infections,” Steves said.   Continued...