Abstract

META-ANALYSIS: PROTON PUMP INHIBITORS AND RISK OF SMALL INTESTINAL BACTERIAL OVERGROWTH

Mishal Yousef Abdullah Alhabi*, Salman Mesfer Alyaseen, Mohammed Abdulrhman Al-Amri, Hamad Mohammed AlSaad, Alaa Naser Kurdi, Abdul Karim Alhomaidi Almutairi, Ahmed Mohammed Alghayyamah, Abdullah Ibrahim Mirdad, Ghassan Khalid Al Harazi, Ali Hussain Alabdullah

Abstract

Background & Purpose: SIBO is a heterogeneous syndrome characterised by an increased in wide variety and/or atypical kind of microorganism in the small bowel. SIBO represents the overgrowth of bacterial species within the proximal small intestine. as a result of SIBO, fermentation of nutritional carbohydrates by using these microorganism results in over production of gas and to the generation of signs of maldigestion or malabsorption. Proton pump inhibitors (PPIs) have turn out to be the mainstay of clinical treatments for a number of conditions, which includes gastroesophageal reflux disorder (GERD), peptic ulcer sickness and Helicobacter pylori infection. Due to their efficacy and usual safety profile, PPIs have grown to be one of the maximum generally prescribed classes of medicines ---. The Aim of this work is to provide cumulative data about the effect of Proton Pump Inhibitors (PPIs) on increasing the risk of Small Intestinal Bacterial Overgrowth (SIBO) in Irritable Bowel Syndrome (IBS) patients. Methods: A systematic search was performed of PubMed, Cochrane library Ovid, Scopus & Google scholar to identify GIT RCTs, clinical trials, and comparative studies, which studied the outcome of PPI users versus Non- PPI users of IBS patients. A meta-analysis was done using fixed and random-effect methods. The main outcome was SIBO incidence. Results: A total of 6 studies were identified involving 2820 IBS patients. Regarding main measure, the fixed- effects model of the meta-analysis study showed significant increase in SIBO incidence in PPI users compared to Non-PPI users (p = 0.015). Conclusion: To conclude, PPI play an important role in increasing the risk of Small Intestinal Bacterial Over growth in intestinal diseases.

Keywords: Proton Pump Inhibitors, Small Intestinal Bacterial Overgrowth, Irritable Bowel Syndrome.