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Recent Advances in Pain Medicine

Proton pump Inhibitors exacerbate NSAID-induced small intestinal injury

Proton Pump Inhibitors Exacerbate NSAID-Induced Small Intestinal Injury by Inducing Dysbiosis: PPI is used along with NSAID for preventing gastric ulcer. However this study in rats showed that the PPIs exacerbate NSAID-induced intestinal damage at least in part because of significant shifts in enteric microbial populations (dysbiosis). They concluded that the prevention or reversal of this alteration of microbial flora may be a viable option for reducing the incidence and severity of NSAID induced enteropathy. Therefore concomitant use of probiotics may prevent small bowel injury from use of PPI along with NSAID by treating dysbiosis.


Wallace JL, Syer S et al.  Proton Pump Inhibitors Exacerbate NSAID-Induced Small Intestinal Injury by Inducing Dysbiosis. Gastroenteroly, July 2011.  

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