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Drug‐induced hypochlorhydria causes high duodenal bacterial counts in the elderly
Author(s) -
Stephen P. Pereira,
Nicola Gainsborough,
R. H. Dowling
Publication year - 1998
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1046/j.1365-2036.1998.00275.x
Subject(s) - medicine , gastroenterology , malabsorption , omeprazole , ranitidine , lactulose , small intestinal bacterial overgrowth , drug , bacterial overgrowth , helicobacter pylori , asymptomatic , pharmacology , irritable bowel syndrome
Background: Small bowel bacterial overgrowth secondary to drug‐induced hypochlorhydria may be of particular importance in the elderly, in whom anti‐ulcer drugs are commonly prescribed and the consequences of malabsorption may be severe. Methods: Duodenal aspirates were obtained from elderly individuals before ( n =24) and during a 2‐month treatment course with either omeprazole (20 mg daily; n =8) or ranitidine (300 mg b.d.; n =6), and from six patients with small bowel bacterial overgrowth who had diarrhoea and malabsorption. Results: Before treatment, duodenal bacterial counts were normal (< 10 4 colony forming units/mL) in 23 elderly subjects (96%). However, six of 14 patients (43%) treated with omeprazole (5 of 8) or ranitidine (1 of 6) developed bacterial counts> 10 5 cfu/mL. All remained asymptomatic and had normal lactulose breath H 2 profiles during treatment. Conclusion: Drug‐induced hypochlorhydria causes high duodenal bacterial counts in the elderly but, in the short term, this bacterial overgrowth is not associated with malabsorption.