P4118 - A Comparative Study on the Occurrence of Small Intestine Bacterial Overgrowth of Proton Pump Inhibitor (PPI) and Potassium-Competitive Acid Blocker (P-CAB)
Catholic University of Korea, St. Vincent's Hospital Suwon-Si, Kyonggi-do, Republic of Korea
Soon-Ju Hwang, MD Catholic University of Korea, St. Vincent's Hospital, Suwon-Si, Kyonggi-do, Republic of Korea
Introduction: Long-term acid suppression with proton pump inhibitors (PPI) leads to hypochlorhydria, and it facilitates the growth of the bacterial flora in small intestine. A novel drug of acid-suppressants, potassium-competitive acid blockers (P-CAB) seems to be superior to PPIs. Up to date, there are limited data for risk of small intestinal bacterial overgrowth (SIBO) in patients receiving P-CABs.
Methods: We analyzed a consecutive series of the patients who had a long-term use of acid-supressants (PPI or P-CAB) due to gastroesophageal reflux disease or NSAIDs induced gastropathy. All of them checked endoscopic examinations and Helicobacter pylori state, and took PPIs or PCAB for at least more than 3 months. For check the occurrence of SIBO, glucose hydrogen breath tests (GBT) were performed, and the newly developed SIBO related symptoms – bloating, postprandial discomfort, diarrhea, and constipation for SIBO were evaluated.
Results: A total 142 patients were enrolled, and 6 patients were ruled out for equivocal results of Helicobacter pylori infection. The frequencies for positive GBT were 31.7% (25/ 79) for PPI and 22.8% (13/ 57) for P-CAB use (P=0.15). The frequencies of positive GBT or occurrence of SIBO related symptoms were 54.4% (43/ 79) for PPI and 28.1% (16/ 57) for P-CAB use (P< 0.01).
Discussion: The frequencies of positive GBT were not different for the patients with long-term use of PPI and P-CAB. When positive results of GBT and the occurrence of SIBO-related symptoms were defined as SIBO, the long-term use of PPI had a higher SIBO incidence.
Figure: Figure 1. The frequencies of positive GBT after use of PPI or P-CAB Figure 2. The frequencies of positive GBT or occurrence of SIBO related symptoms after use of PPI or P-CAB
Disclosures:
Soon-Ju Hwang indicated no relevant financial relationships.
Soon-Ju Hwang, MD. P4118 - A Comparative Study on the Occurrence of Small Intestine Bacterial Overgrowth of Proton Pump Inhibitor (PPI) and Potassium-Competitive Acid Blocker (P-CAB), ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.
