SynthesisUnited European gastroenterology journal2023
Impact of proton pump inhibitors on the risk of small bowel or colorectal bleeding: A systematic review and meta-analysis.
Synthesis in United European gastroenterology journal, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis 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.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 citations in OpenAlex.
- Impact of proton pump inhibitors on the risk of small bowel or colorectal bleeding: A systematic review and meta-analysis.United European gastroenterology journal · 2023Pooled it
- Comparative Efficacy of Rebamipide, Pantoprazole, and Their Combination for Gastroprotection in Patients with Atrial Fibrillation Receiving Direct Oral Anticoagulants: The Randomized REGATA Study.Medical sciences (Basel, Switzerland) · 2026Trial
- Migration of a Hem-O-Lok clip into the cecal lumen following laparoscopic appendectomy: a case report.BMC gastroenterology · 2026Article
- Pyroptosis-immunity-microbiome axis in acute upper gastrointestinal bleeding: mechanisms, risk prediction, and individualized strategies.Frontiers in medicine · 2026Review
- Mass-Forming NSAID-Associated Colopathy Mimicking Right-Sided Colon Cancer: A Case Report.Case reports in pathology · 2026Article
- Proton pump inhibitors have no effect on short or long term rebleeding or mortality in patients with overt gastrointestinal bleeding.Scientific reports · 2025Article
- Article
- Appropriateness of proton pump inhibitor prescription for prevention of gastrointestinal bleeding in patients receiving warfarin: a real world, database study.BMC pharmacology & toxicology · 2025Article
- Impact of enhanced bowel preparation on complications and prognosis following colonoscopic polypectomy.World journal of gastrointestinal surgery · 2025Article
- Risk of Lower Gastrointestinal Bleeding in Nonsteroidal Anti-inflammatory Drug (NSAID) and Proton Pump Inhibitor Users Compared with NSAID-Only Users: A Common Data Model Analysis.Gut and liver · 2025Observational
- Pharmacovigilance analysis of small bowel bleeding associated with NSAIDs.Therapeutic advances in drug safety · 2025Article
- Proton Pump Inhibitors and Oral-Gut Microbiota: From Mechanism to Clinical Significance.Biomedicines · 2024Review
- Reduced risk of gastrointestinal bleeding associated with eupatilin in aspirin plus acid suppressant users: nationwide population-based study.The Korean journal of internal medicine · 2024Article
Corrections and comments
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Authors and funding
3 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSeveral studies have suggested that the mucosal protective effects of proton pump inhibitors (PPIs) do not extend beyond the duodenum; however, PPIs may cause lower gastrointestinal (LGI) injury, although these relationships have not yet been fully elucidated.
methodsWe searched all the relevant studies published until September 2022 that examined the risk of PPIs for LGI bleeding. We performed a meta-analysis of the risk of LGI bleeding (small bowel (SB) or colorectal bleeding) between PPI users and non-users. A subgroup analysis of patients consuming aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) was also performed.
resultsTwelve studies with 341,063 participants were included in this meta-analysis. The use of PPIs was associated with the risk of LGI bleeding (odds ratio [OR] [95% confidence interval [CI]] = 1.42 [1.16-1.73]; hazard ratio [HR] [95% CI] = 3.23 [1.56-6.71]). An association between PPI use and the risk of LGI bleeding was also identified in the subgroup of aspirin or NSAID users (OR [95% CI] = 1.64 [1.49-1.80]; HR [95% CI] = 6.55 [2.01-21.33]). In the bleeding site-specific analyses, the risk of SB bleeding was associated with PPI use (OR [95% CI] = 1.54 [1.30-1.84]).
conclusionsPPI use was associated with an increased risk of LGI bleeding, particularly SB bleeding. This association was particularly pronounced among aspirin and NSAID users. Inappropriate PPI prescriptions should be avoided in patients with LGI bleeding and a low risk of upper gastrointestinal disease.
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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.