Proton pump inhibitors, or PPIs for short, have become a mainstay as heartburn drugs. Once available only by prescription, powerful acid-suppressing drugs such as omeprazole (Prilosec), lansoprazole (Prevacid) and esomeprazole (Nexium) are now available over the counter. They are no longer restricted to the treatment of ulcers and severe gastroesophageal reflux disease, as they initially were, but now are widely used for many kinds of digestive distress.
But is it wise for so many people to be taking PPI heartburn drugs, or for people to take them for so long? New research from the Netherlands suggests that these medications can change the balance of bacteria living in the intestinal tract.
Consequences of Heartburn Drugs for Bacterial Balance in the Digestive Tract:
Dutch researchers analyzed the DNA of fecal samples from 1,815 adults. They found that those taking proton pump inhibitors have fewer types of beneficial bacteria and more potentially dangerous bacteria.
Such changes in the ecology of the gut appear to increase the risk for infection with Clostridium difficile, also known as C. diff. This organism can cause severe, hard-to-treat diarrhea.
This is hardly the first time that we have heard that long-term use of PPI medications could boost the chance of recurrent C. diff. infections. A report in JAMA Internal Medicine in May, 2015, showed that many hospitalized patients are at significantly increased risk of multiple C. diff. infections if they remain on these heartburn drugs. Although it can be very difficult to discontinue such medicines, the effort pays off when the person is no longer susceptible to repeated bouts of life-threatening diarrhea.
You can learn more about PPIs and other ways to manage heartburn in our Guide to Digestive Disorders.