| Theme |
Treatment of Acid‒related Diseases -- the Past, Present and Future |
| Title |
Increased Risk of Colorectal Disease Associated with Intestinal Bacterial Overgrowth during Acid—secretion Inhibitor Therapy |
| Author |
Izumi Inoue |
Tokyo University of Marine Science and Technology |
| Author |
Takao Maekita |
Department of Gastroenterology, Wakayama Medical University |
| Author |
Jun Kato |
Department of Gastroenterology, Wakayama Medical University |
| Author |
Masao Ichinose |
Teikyo University of Medicine |
| [ Summary ] |
The use of proton pump inhibitors (PPIs) has generally been considered safe, with low reported incidences of serious adverse events. However, recently, a number of side effects have been reported ; hypochlorhydria caused by strong acid secretion inhibitors such as PPIs, a previous history of gastric resection and severe extensive atrophic gastritis are considered to be related to the overgrowth of intestinal microflora. Several studies have indicated that hypochlorhydria is directly related to the overgrowth of intestinal bacteria, which may lead to C. difficile infections and other enteric infections including Salmonella and Campylobacter, and finally to colorectal neoplasia. Before initiating strong acid‒inhibitory therapy, full consideration of its risks and benefits should be given, and unnecessary long‒term prescription should be avoided to minimize potential adverse events. |