Abstract | BACKGROUND: AIM: To evaluate the effects of long-term PPI treatment on development of bowel symptoms and/or small intestinal bacterial overgrowth (SIBO). METHODS: Patients with NERD not complaining of bowel symptoms were selected by upper endoscopy, 24-h pH-metry and a structured questionnaire concerning severity and frequency of bloating, flatulence, abdominal pain, diarrhoea and constipation. Patients were treated with esomeprazole 20 mg bid for 6 months. Prior to and after 8 weeks and 6 months of therapy, patients received the structured questionnaire and underwent evaluation of SIBO by glucose hydrogen breath test (GHBT). RESULTS: Forty-two patients with NERD were selected out of 554 eligible patients. After 8 weeks of PPI treatment, patients complained of bloating, flatulence, abdominal pain and diarrhoea in 43%, 17%, 7% and 2%, respectively. After 6 months, the incidence of bowel symptoms further increased and GHBT was found positive in 11/42 (26%) patients. By a post hoc analysis, a significant (P < 0·05) percentage of patients (8/42) met Rome III criteria for irritable bowel syndrome. CONCLUSIONS: Prolonged PPI treatment may produce bowel symptoms and SIBO; therefore, the strategy of step-down or on-demand PPI therapy should be encouraged in GERD.
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Authors | Debora Compare, Loredana Pica, Alba Rocco, Francesco De Giorgi, Rosario Cuomo, Giovanni Sarnelli, Marco Romano, Gerardo Nardone |
Journal | European journal of clinical investigation
(Eur J Clin Invest)
Vol. 41
Issue 4
Pg. 380-6
(Apr 2011)
ISSN: 1365-2362 [Electronic] England |
PMID | 21128930
(Publication Type: Journal Article)
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Copyright | © 2010 The Authors. European Journal of Clinical Investigation © 2010 Stichting European Society for Clinical Investigation Journal Foundation. |
Chemical References |
- Proton Pump Inhibitors
- Esomeprazole
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Topics |
- Adult
- Esomeprazole
(adverse effects)
- Female
- Gastroesophageal Reflux
(drug therapy, physiopathology)
- Humans
- Intestines
(drug effects, microbiology)
- Irritable Bowel Syndrome
(chemically induced, physiopathology)
- Italy
- Male
- Middle Aged
- Proton Pump Inhibitors
(adverse effects)
- Time Factors
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