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

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Abstract

Background: 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. Methods: 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. Results: 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. Conclusion: 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.

Original languageEnglish
Article numbere0182586
JournalPloS one
Volume12
Issue number8
DOIs
Publication statusPublished - 08-2017

All Science Journal Classification (ASJC) codes

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)
  • General

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    Yamada, A., Niikura, R., Maki, K., Nakamura, M., Watabe, H., Fujishiro, M., Oka, S., Fujimori, S., Nakajima, A., Ohmiya, N., Matsumoto, T., Tanaka, S., Koike, K., & Sakamoto, C. (2017). Proton pump inhibitor therapy did not increase the prevalence of small-bowel injury: A propensity-matched analysis. PloS one, 12(8), [e0182586]. https://doi.org/10.1371/journal.pone.0182586