SynthesisFrontiers in nutrition2026
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.
Synthesis in Frontiers in nutrition, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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18 authors.
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Abstract
Introduction: Gastroesophageal reflux disease (GERD) and proton pump inhibitor (PPI) therapy have both been associated with alterations of the developing gastrointestinal microbiome and potential downstream clinical consequences in children. However, available evidence is fragmented across disease-related, treatment-related, and mechanistic studies, making the overall biological relationship difficult to interpret. Methods: PubMed, Web of Science, and Scopus databases were queried for the period January 2000 to May 2026 to synthesize evidence across the pathophysiological continuum linking pediatric GERD, microbiota alterations, inflammatory mechanisms, PPI exposure, and microbiota-associated clinical outcomes. Results: The review included studies evaluating children with GERD as well as mechanistic studies involving pediatric upper gastrointestinal conditions requiring PPI therapy when microbiota-related outcomes were relevant to the review objective. Study selection was performed according to PRISMA guidelines, 31 of which were included in the final analysis. The data indicate that pediatric exposure to GERD and PPI is associated with changes in the gastrointestinal microbiota at multiple levels (oral, esophageal, gastric, and intestinal). These changes include reduced microbial diversity, changes in bacterial composition (particularly Conclusion: Pediatric GERD and PPI exposure are associated with alterations in the gastrointestinal microbiome and possible systemic clinical effects. Most evidence is heterogeneous and influenced by confounding factors, which limits the establishment of a causal relationship. Prospective longitudinal and mechanistic studies using standardized microbiome methodologies are required to clarify causality and better define the respective contributions of GERD and PPI therapy to microbiota alterations and their clinical significance. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD420261405291, identifier CRD420261405291.
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