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

• Published in: PloS one Vol. 12; no. 8; p. e0182586
• Main Authors: Yamada, Atsuo, Niikura, Ryota, Maki, Koutarou, Nakamura, Masanao, Watabe, Hirotsugu, Fujishiro, Mitsuhiro, Oka, Shiro, Fujimori, Shunji, Nakajima, Atsushi, Ohmiya, Naoki, Matsumoto, Takayuki, Tanaka, Shinji, Koike, Kazuhiko, Sakamoto, Choitsu
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 03.08.2017; Public Library of Science (PLoS)
• Subjects: Abdominal Injuries - chemically induced; Abdominal Injuries - epidemiology; Aged; Aged, 80 and over; Angina pectoris; Anti-inflammatory agents; Anti-Inflammatory Agents, Non-Steroidal - therapeutic use; Anticoagulants; Biology and Life Sciences; Capsule Endoscopy - methods; Complications and side effects; Dosage and administration; Drug dosages; Drug therapy; Drugs; Endoscopy; Female; Gastroenterology; Gastrointestinal diseases; Hepatology; Hospitals; Humans; Hypertension; Inflammation; Injuries; Injury analysis; Intestine, Small - diagnostic imaging; Intestine, Small - drug effects; Intestine, Small - injuries; Lesions; Male; Matching; Medical schools; Medicine; Medicine and health sciences; Microbiota (Symbiotic organisms); Nonsteroidal anti-inflammatory drugs; Patients; Physiological aspects; Prevalence; Propensity Score; Proton pump inhibitors; Proton Pump Inhibitors - adverse effects; Proton Pump Inhibitors - pharmacology; Retrospective Studies; Risk Factors; Secretion; Small intestine; Studies; Therapy; Ulcers; Japan
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0182586

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.