Open AccessProton pump inhibitor therapy did not increase the prevalence of small-bowel injury: A propensity-matched analysis
Author(s) -
Atsuo Yamada,
Ryota Niikura,
Koutarou Maki,
Masanao Nakamura,
Hirotsugu Watabe,
Mitsuhiro Fujishiro,
Shiro Oka,
Shunji Fujimori,
Atsushi Nakajima,
Naoki Ohmiya,
Takayuki Matsumoto,
Shinji Tanaka,
Kazuhiko Koike,
Choitsu Sakamoto
Publication year - 2017
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0182586
Subject(s) - medicine , propensity score matching , capsule endoscopy , gastroenterology , proton pump inhibitor , inflammatory bowel disease , omeprazole , disease
Background Previous studies have reported that the suppression of acid secretion by using proton pump inhibitors (PPIs) results in dysbiosis of the small-bowel microbiota, leading to exacerbated small-bowel injuries, including erosions and ulcers. This study was designed to assess the association between PPI therapy and small-bowel lesions after adjustment for the differences in baseline characteristics between users and non-users of PPIs. Methods We retrospectively studied patients suspected to be suffering from small-bowel diseases, who underwent capsule endoscopy between 2010 and 2013. We used propensity matching to adjust for the differences in baseline characteristics between users and non-users of PPIs. The outcomes included the prevalence of small-bowel lesions: erosion, ulcer, angioectasia, varices, and tumor. Results We selected 327 patient pairs for analysis after propensity matching, and found no significant differences in the prevalence of small-bowel injuries, including erosions and ulcers, between users and non-users of PPIs. Two subgroup analyses of the effect of the type of PPI and the effect of PPI therapy in users and non-users of nonsteroidal anti-inflammatory drugs indicated no significant differences in the prevalence of small-bowel injuries in these two groups. Conclusion PPI therapy did not increase the prevalence of small-bowel injury, regardless of the type of PPI used and the use of nonsteroidal anti-inflammatory drugs.