Impact of proton pump inhibitor use on microbiota and diversity
Abstract
Proton pump inhibitors are a class of drugs specifically administered to alleviate stomach acid. In cases of GERD, general GI disturbances and other medication-related GI symptoms, PPIs are widely prescribed globally. Typically, patients taking PPIS have a history of long-term use, which can lead to various health issues. Gut health primarily depends on gut microbiota and dysbiosis of the microbiota can result in numerous metabolic and infectious disorders. Recent research has focused on the impact of PPI usage on the diversity and composition of microbiota. This systematic review aimed to summarize the key findings from studies conducted from January 2015 to June 2025, including only interventional, cohort and case-control studies. After screening 1861 articles sourced from PubMed, Scopus, Clinical trials and other databases, only 12 studies were included in this review. Data revealed that both alpha and beta diversity are significantly increased in individuals after PPI use and there is a significant increase in the colonies of Streptococcus, Staphylococcus and pathogenic microbes such as E. coli. It has also been summarized that PPI intake can result in IBS and autoimmune disorders. Therefore, the unregulated use of PPIs should be restricted and research should be conducted to provide better alternatives.
How strong is the evidence?
Evidence Hub reads this as a case-control, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause.
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