Acid suppression increases gastroenteritis risk

Proton pump inhibitors (PPIs) and H2 receptor antagonists seem to increase the risk of bacterial gastroenteritis, according to research in the British Journal of Clinical Pharmacology.

Researchers reviewed the medical records of 188,323 people in Scotland who took acid suppressants and 376,646 controls who did not. People who took PPIs or H2 antagonists were almost three times more likely (adjusted hazard ratios [HR] 2.72) to have culturepositive diarrhoea based on stool samples taken in the community than controls.

The risk of bacterial gastroenteritis was 28 per cent higher in people taking PPIs or H2 antagonists based on stool samples from hospitals.

Compared with controls, patients who took PPIs or H2 antagonists had increased risks of gastroenteritis associated with Clostridium difficile (HR 1.70 and 1.42 for community and hospital samples respectively) and Campylobacter (HR 3.71 and 4.53 respectively). In 2012, exposure to PPIs or H2 antagonists accounted for an estimated 27.1 per cent of cases of bacterial gastroenteritis in the community.


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