ArticleGut2016
Proton pump inhibitors affect the gut microbiome.
Article in Gut, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02893709 (Factors Influencing the Human Gut Microbiome Profile in Multi-ethnic Groups of the Singapore Community), which is not on this map. Cited by 758 papers, 7 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Factors Influencing the Human Gut Microbiome Profile in Multi-ethnic Groups of the Singapore Community (FAMES)
Who cites it
758 citing papers in PubMed, 7 syntheses or guidelines pooled it, 1,285 citations in OpenAlex.
- Exploring gut microbiome dysbiosis in vasculitis in adults: a systematic review.Systematic reviews · 2026Pooled it
- Pooled it
- The association between proton pump inhibitor use and the risk of mortality in patients with kidney disease: a systematic review and meta-analysis.European journal of clinical pharmacology · 2026Pooled it
- Coordinated oral-gut microbiota relocation in connective tissue diseases: a systematic review.Frontiers in immunology · 2026Pooled it
- Gastrointestinal microbiota alterations associated with pediatric gastroesophageal reflux disease and proton pump inhibitor exposure: a systematic review of microbiome changes, dysbiosis markers, and associated clinical outcomes.Frontiers in nutrition · 2026Pooled it
- Association between proton pump inhibitor use and migraine: a systematic review and meta-analysis.The journal of headache and pain · 2025Pooled it
- Comparison of the gut microbiota in older people with and without sarcopenia: a systematic review and meta-analysis.Frontiers in cellular and infection microbiology · 2025Pooled it
- Immediate discontinuation versus gradual tapering of proton pump inhibitors in long-term users: a randomized controlled trial.Journal of gastroenterology · 2026Trial
- A Mycophenolate Pharmacokinetic Study with New Insights into Enterohepatic Recirculation in Kidney Transplant Recipients.Clinical pharmacokinetics · 2026Trial
- Effect of curcumin on the gut microbiota of patients with ulcerative colitis, Crohn's disease and healthy participants.Scientific reports · 2026Trial
- Trial
- Article
- Microbial metabolite-driven mechanisms linking the gut microbiome to atherosclerosis: multi-omic and translational perspectives.Gut microbes · 2026Review
- Lactic acid bacteria and endogenous ethanol mediate proton pump inhibitor-associated MASLD: a multicohort cross-sectional mediation analysis.Gut microbes · 2026Article
- Gut microbiome remodeling induced by microplastic exposure in humans.Gut microbes · 2026Review
- From gut dysbiosis to eubiosis: understanding microbiome recovery as an ecological process.Gut microbes · 2026Review
- Recent advances and clinical relevance of microbiome dynamics in health and disease.Gut microbes · 2026Review
- Microbes and medicines: interrelationships between pharmaceuticals and the gut microbiome.Gut microbes · 2026Review
- Eight-Year Trends in Nationwide Proton Pump Inhibitor Use Among Finnish Children Under 6 Years by Sector and Specialty.Paediatric drugs · 2026Article
- Role of the Gut Microbiome in Natural and Synthetic Drug Efficacy and Safety: A Narrative Review.Applied microbiology (Basel, Switzerland) · 2026Article
698 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
17 authors at 4 institutions in 2 countries.
Funding
Abstract
BACKGROUND AND
aimsProton pump inhibitors (PPIs) are among the top 10 most widely used drugs in the world. PPI use has been associated with an increased risk of enteric infections, most notably Clostridium difficile. The gut microbiome plays an important role in enteric infections, by resisting or promoting colonisation by pathogens. In this study, we investigated the influence of PPI use on the gut microbiome.
methodsThe gut microbiome composition of 1815 individuals, spanning three cohorts, was assessed by tag sequencing of the 16S rRNA gene. The difference in microbiota composition in PPI users versus non-users was analysed separately in each cohort, followed by a meta-analysis.
results211 of the participants were using PPIs at the moment of stool sampling. PPI use is associated with a significant decrease in Shannon's diversity and with changes in 20% of the bacterial taxa (false discovery rate <0.05). Multiple oral bacteria were over-represented in the faecal microbiome of PPI-users, including the genus Rothia (p=9.8×10(-38)). In PPI users we observed a significant increase in bacteria: genera Enterococcus, Streptococcus, Staphylococcus and the potentially pathogenic species Escherichia coli.
conclusionsThe differences between PPI users and non-users observed in this study are consistently associated with changes towards a less healthy gut microbiome. These differences are in line with known changes that predispose to C. difficile infections and can potentially explain the increased risk of enteric infections in PPI users. On a population level, the effects of PPI are more prominent than the effects of antibiotics or other commonly used drugs.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.