A Study on the Glucose Breath Test Positivity Rate and Occurrence of Small Intestine Bacterial Overgrowth-Related Symptoms Caused by Long-Term Use of Proton Pump Inhibitor (PPI) Versus Potassium-Competitive Acid Blocker (P-CAB) in Elderly Patients: SIBO Between PPI and P-CAB.

IF 2.1 Q3 PHARMACOLOGY & PHARMACY Advances in Pharmacological and Pharmaceutical Sciences Pub Date : 2024-10-29 eCollection Date: 2024-01-01 DOI:10.1155/2024/6069151
Na Rae Lim, Saenal Lim, Woo Chul Chung
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Abstract

Background/Aims: Long-term acid suppression with proton pump inhibitors (PPI) leads to hypochlorhydria and facilitates the growth of bacterial flora in the small intestine. Novel acid-suppressants called potassium-competitive acid blockers (P-CABs) seem to be superior to PPIs. However, data on the risk of small intestinal bacterial overgrowth (SIBO) in patients taking P-CABs are limited. Method: We retrospectively analyzed a consecutive series of patients with long-term acid-suppressant (PPIs or P-CABs) use for gastroesophageal reflux disease or nonsteroidal anti-inflammatory drug (NSAID)-induced gastropathy. All of them underwent endoscopic examinations and Helicobacter pylori testing and took PPIs or P-CABs for at least 3 months. Glucose hydrogen breath tests (GBT) were performed to check for SIBO, and newly developed SIBO-related symptoms including bloating, postprandial discomfort, diarrheas, and constipation, were evaluated. Results: A total of 142 patients were enrolled. Six patients were excluded due to equivocal Helicobacter pylori infection results. The frequency of positive GBTs was 31.7% (25/79) for PPI and 22.8% (13/57) for P-CAB use (p=0.15). Regarding GBT positivity, age-related factor was found to be significant in multivariate analysis (p=0.02). The results of multivariate analysis in cases of SIBO-related symptoms showed that GBT positivity and PPI use were significant (p < 0.01). Conclusion: Long-term use of gastric acid suppressants resulted in positive GBT in approximately 30% of patients, and the risk was particularly high in elderly patients. The occurrence of SIBO-related symptoms was significant in long-term use of PPIs and in patients with positive GBT.

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一项关于老年患者长期服用质子泵抑制剂(PPI)与钾竞争性酸阻滞剂(P-CAB)导致的葡萄糖呼气试验阳性率和小肠细菌过度生长相关症状发生率的研究:PPI 和 P-CAB 之间的 SIBO。
背景/目的:长期使用质子泵抑制剂(PPI)抑酸会导致低氯血症,并促进小肠中细菌菌群的生长。被称为钾竞争性酸阻滞剂(P-CABs)的新型抑酸剂似乎优于质子泵抑制剂。然而,有关服用 P-CABs 的患者小肠细菌过度生长(SIBO)风险的数据却很有限。方法:我们对长期服用抑酸剂(PPIs 或 P-CABs)治疗胃食管反流病或非类固醇抗炎药(NSAID)引起的胃病的一系列患者进行了回顾性分析。他们都接受了内窥镜检查和幽门螺旋杆菌检测,并服用 PPIs 或 P-CABs 至少 3 个月。他们还进行了葡萄糖氢呼气试验(GBT)以检查是否存在 SIBO,并对新出现的 SIBO 相关症状(包括腹胀、餐后不适、腹泻和便秘)进行了评估。结果共有 142 名患者入选。有六名患者因幽门螺旋杆菌感染结果不明确而被排除在外。使用 PPI 的 GBT 阳性率为 31.7%(25/79),使用 P-CAB 的 GBT 阳性率为 22.8%(13/57)(P=0.15)。关于 GBT 阳性,在多变量分析中发现与年龄有关的因素具有显著性(P=0.02)。对出现 SIBO 相关症状的病例进行多变量分析的结果显示,GBT 阳性和使用 PPI 具有显著意义(p < 0.01)。结论长期使用胃酸抑制剂导致约 30% 的患者出现 GBT 阳性,老年患者的风险尤其高。长期使用 PPI 和 GBT 呈阳性的患者出现 SIBO 相关症状的几率很大。
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CiteScore
4.30
自引率
3.60%
发文量
0
审稿时长
17 weeks
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