Evidence map›Paper›PMID 26719299›Full record

ArticleGut2016

Proton pump inhibitors alter the composition of the gut microbiota.

Matthew A Jackson, Julia K Goodrich, Maria-Emanuela Maxan, Daniel E Freedberg, Julian A Abrams, Angela C Poole, Jessica L Sutter, Daphne Welter, Ruth E Ley, Jordana T Bell and 2 more

Registry-linked trialAbstract read
PubMed Full text at PMC Publisher
In one paragraph

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 487 papers, 11 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
487citing papers in PubMed, 11 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

NCT02893709 nacompletednot on this map

Factors Influencing the Human Gut Microbiome Profile in Multi-ethnic Groups of the Singapore Community (FAMES)

TypeinterventionalSponsorChangi General HospitalRan2015 to 2016Enrolled36ConditionsGastroesophageal Reflux DiseaseArmsOmeprazole
3 · Its place in the literature

Who cites it

487 citing papers in PubMed, 11 syntheses or guidelines pooled it.

  1. Pooled it
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  5. Proton pump inhibitors and risk of hearing loss; a systematic review.Naunyn-Schmiedeberg's archives of pharmacology · 2025
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  17. Therapeutic Evaluation ofNutrients · 2024
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  19. Review
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427 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

12 authors.

Matthew A JacksonDepartment of Twin Research and Genetic Epidemiology, King's College London, London, UK.ORCID http://orcid.org/0000-0002-7891-6217
Julia K GoodrichDepartment of Molecular Biology and Genetics, Cornell University, Ithaca, New York, USA Department of Microbiology, Cornell University, Ithaca, New York, USA.
Maria-Emanuela MaxanClinical Age Research Unit, Kings College Hospital Foundation Trust, London, UK.
Daniel E FreedbergDivision of Digestive and Liver Diseases, Department of Medicine, Columbia University Medical Center, New York, New York, USA.
Julian A AbramsDivision of Digestive and Liver Diseases, Department of Medicine, Columbia University Medical Center, New York, New York, USA.
Angela C PooleDepartment of Molecular Biology and Genetics, Cornell University, Ithaca, New York, USA Department of Microbiology, Cornell University, Ithaca, New York, USA.
Jessica L SutterDepartment of Molecular Biology and Genetics, Cornell University, Ithaca, New York, USA Department of Microbiology, Cornell University, Ithaca, New York, USA.
Daphne WelterDepartment of Molecular Biology and Genetics, Cornell University, Ithaca, New York, USA Department of Microbiology, Cornell University, Ithaca, New York, USA.
Ruth E LeyDepartment of Molecular Biology and Genetics, Cornell University, Ithaca, New York, USA Department of Microbiology, Cornell University, Ithaca, New York, USA.
Jordana T BellDepartment of Twin Research and Genetic Epidemiology, King's College London, London, UK.
Tim D SpectorDepartment of Twin Research and Genetic Epidemiology, King's College London, London, UK.
Claire J StevesDepartment of Twin Research and Genetic Epidemiology, King's College London, London, UK.

Funding

Translational Research CoreP30DK020541 · NIDDK · ALBERT EINSTEIN COLLEGE OF MEDICINE, INC · PI JILL CRANDALL · 2015 to 2026
$27.7M
Genetic Transmission of Components of the Human Gut MicrobiomeR01DK093595 · NIDDK · CORNELL UNIVERSITY · PI CLARK, ANDREW G, LEY, RUTH EMILY · 2011 to 2020
$3.5M
Clinical and Translational Science AwardKL2TR000081 · NCATS · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI GINSBERG, HENRY N · 2012 to 2015
$3.3M
Development of immunization strategies to reshape pathogenic microbiomesDP2OD007444 · OD · CORNELL UNIVERSITY · PI LEY, RUTH EMILY · 2010 to 2010
$2.3M
NCATS NIH HHS KL2 TR000081NIDDK NIH HHS P30 DK020541NIDDK NIH HHS R01 DK093595NIH HHS DP2 OD007444Wellcome Trust
6 · The paper itself

Abstract

objectiveProton pump inhibitors (PPIs) are drugs used to suppress gastric acid production and treat GI disorders such as peptic ulcers and gastro-oesophageal reflux. They have been considered low risk, have been widely adopted, and are often over-prescribed. Recent studies have identified an increased risk of enteric and other infections with their use. Small studies have identified possible associations between PPI use and GI microbiota, but this has yet to be carried out on a large population-based cohort.

designWe investigated the association between PPI usage and the gut microbiome using 16S ribosomal RNA amplification from faecal samples of 1827 healthy twins, replicating results within unpublished data from an interventional study.

resultsWe identified a significantly lower abundance in gut commensals and lower microbial diversity in PPI users, with an associated significant increase in the abundance of oral and upper GI tract commensals. In particular, significant increases were observed in Streptococcaceae. These associations were replicated in an independent interventional study and in a paired analysis between 70 monozygotic twin pairs who were discordant for PPI use. We propose that the observed changes result from the removal of the low pH barrier between upper GI tract bacteria and the lower gut.

conclusionsOur findings describe a significant impact of PPIs on the gut microbiome and should caution over-use of PPIs, and warrant further investigation into the mechanisms and their clinical consequences.

Indexed as

AdultAgedAged, 80 and overFemaleGastrointestinal MicrobiomeHumansMaleMiddle AgedProton Pump InhibitorsUpper Gastrointestinal TractYoung AdultProton Pump InhibitorsGASTRIC ACIDINTESTINAL MICROBIOLOGYLACTIC ACID BACTERIALACTOBACILLUSPROTON PUMP INHIBITION

Identifiers

PMID26719299
PMCPMC4853574

What OpenQuestion holds

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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.