Highlights from

UEGW 2019

United European Gastroenterology Week 2019

Barcelona, Spain 19 - 23 October 2019

Half of common medications wreak havoc on gut microbiome

A new study by researchers at the University Medical Center Groningen and the Maastricht University Medical Center (the Netherlands) has found that 18 commonly used drug categories extensively affect the taxonomic diversity and metabolic potential of the gut microbiome [1]. Eight different categories of drugs were also found to increase antimicrobial resistance mechanisms in the study participants.

The investigators looked at 41 commonly used drug categories and assessed 1,883 faecal samples from a population-based healthy cohort, patients with inflammatory bowel disease (IBD), and patients with irritable bowel syndrome (IBS) intermixed with healthy controls. The researchers compared the profiles based on taxonomic characteristics and metabolic functions of medication users to non-medication users, looking at the effect of single medication use and then combined medication use. Among the drug categories, the researchers found that those with the biggest impact on the microbiome include proton pump inhibitors (PPIs), which are taken by >11% of the European population. PPIs are used to treat dyspepsia, peptic ulcers, in the eradication of H. Pylori, gastro-reflux, as well as Barrett's oesophagus. Similarly, metformin, commonly used as a treatment for Type 2 diabetes, affected the gut microbiome significantly. Not surprisingly, antibiotics, taken by 34% of the European population each year, made it to the top modulator drug categories. Finally, laxatives also restructured the taxonomy and metabolism of the gut microbiome.

Notable findings were that the gut microbiota of PPI users showed increased abundance of upper gastrointestinal tract bacteria and increased fatty acid production, while metformin users had higher levels of the potentially harmful bacteria E. coli.

The researchers also found that an additional 7 drug categories were associated with significant changes in bacterial populations in the gut. SSRI-antidepressant use in patients with IBS was associated with excessive levels of the potentially harmful bacteria species Eubacterium ramulus. The use of oral steroids was associated with high levels of methanogenic bacteria which has been associated with weight gain and obesity.

The authors concluded that the changes observed as a result of common medication use likely increase the risk of intestinal infections, obesity, and other serious conditions and disorders linked to the gut microbiome in the general population, with specific risks being increased in patients with a digestive disorder such as IBD or IBS.

  1. Vich Vila A et al. Impact of 41 commonly used drugs on the composition, metabolic function and resistome of the gut microbiome. UEG Week Barcelona, Catalonia, Spain, October 19-23, 2019, Abstract OP334.

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