Scientists at the Mayo Clinic noted that people taking the strong acid-suppressing drugs called proton pump inhibitors (PPIs) to treat reflux are more susceptible to intestinal infections such as those caused by Clostridium difficile. In such infections, a type of bacteria that is normally a minor part of the gut flora often takes advantage of an opportunity created by antibiotics killing off other intestinal bacteria and disrupting the ecology of the system, leaving an open niche. When C. diff flourishes, the result for the human host can be intractable diarrhea. (Learn more from this interview.)
To find out whether PPIs such as esomeprazole (Nexium), lansoprazole (Prevacid), omeprazole (Prilosec), pantoprazole (Protonix) or rabeprazole (AcipHex) diminish the diversity of intestinal flora, the investigators took fecal samples from nine volunteers. The participants were given omeprazole.
DNA Tells the Tale
DNA analyses of the samples were run at baseline, one week into the study and after a month of omeprazole treatment. This helps to identify bacterial denizens that can’t be easily cultured.
The hypothesis that PPIs disrupt the healthy human gut microbiome was supported by the findings. The diversity of bacteria apparent from DNA analysis dropped throughout the study, and by the end of the month, it resembled the reduced bacterial diversity found in the intestines of people suffering from C. diff. Fortunately, after discontinuing omeprazole the volunteers regained most of their gut bacteria diversity.
