Skip to main content
Log in

The Effect of PPI Use on Human Gut Microbiota and Weight Loss in Patients Undergoing Laparoscopic Roux-en-Y Gastric Bypass

  • Brief Communication
  • Published:
Obesity Surgery Aims and scope Submit manuscript

Abstract

Laparoscopic Roux-en-Y gastric bypass (LRYGB) achieves sustainable weight loss possibly by altering the gut microbiota. The effect of a proton pump inhibitor (PPI) on weight loss and the gut microbiota has not been explored. PPI use and the gut microbiota were assessed before and 6 months after LRYGB in eight patients. Bacterial profiles were generated by 16S ribosomal RNA (rRNA) gene sequencing. Prior to LRYGB, PPI users had a higher percent relative abundance (PRA) of Firmicutes compared to nonusers. PPI users at 6 months post-LRYGB had a higher PRA of Firmicutes [48.6 versus 35.6 %, p = nonsignificant (NS)] and a trend toward significantly lower percent excess weight loss (49.3 versus 61.4 %, p = 0.067) compared to nonusers. PPI use post-LRYGB may impair weight loss by modifying gut microbiota.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Abbreviations

PRA:

Percent relative abundance

PPI:

Proton pump inhibitor

RYGB:

Roux-en-Y gastric bypass

LRYGB:

Laparoscopic Roux-en-Y gastric bypass

PWL:

Percent weight loss

PEWL:

Percent excess weight loss

NS:

Nonsignificant

References

  1. Ley RE et al. Obesity alters gut microbial ecology. Proc Natl Acad Sci U S A. 2005;102(31):11070–5.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  2. Turnbaugh PJ et al. A core gut microbiome in obese and lean twins. Nature. 2009;457(7228):480–4.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  3. Turnbaugh PJ et al. An obesity-associated gut microbiome with increased capacity for energy harvest. Nature. 2006;444(7122):1027–31.

    Article  PubMed  Google Scholar 

  4. Jumpertz R et al. Energy-balance studies reveal associations between gut microbes, caloric load, and nutrient absorption in humans. Am J Clin Nutr. 2011;94(1):58–65.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  5. Buchwald H et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292(14):1724–37.

    Article  CAS  PubMed  Google Scholar 

  6. Furet JP et al. Differential adaptation of human gut microbiota to bariatric surgery-induced weight loss: links with metabolic and low-grade inflammation markers. Diabetes. 2010;59(12):3049–57.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  7. Graessler J et al. Metagenomic sequencing of the human gut microbiome before and after bariatric surgery in obese patients with type 2 diabetes: correlation with inflammatory and metabolic parameters. Pharmacogenomics J. 2012;2(10):43.

    Google Scholar 

  8. Liou AP, et al. Conserved shifts in the gut microbiota due to gastric bypass reduce host weight and adiposity. Sci Transl Med., 2013. 5(178): p. 178ra41. doi: 10.1126/scitranslmed.3005687.

  9. Friedenberg FK et al. The association between gastroesophageal reflux disease and obesity. Am J Gastroenterol. 2008;103(8):2111–22.

    Article  PubMed  Google Scholar 

  10. Yoshikawa I et al. Long-term treatment with proton pump inhibitor is associated with undesired weight gain. World J Gastroenterol. 2009;15(38):4794–8.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  11. Lo WK, Chan WW. Proton pump inhibitor use and the risk of small intestinal bacterial overgrowth: a meta-analysis. Clin Gastroenterol Hepatol. 2012;24(12):011.

    CAS  Google Scholar 

  12. Michalek W, Semler JR, Kuo B. Impact of acid suppression on upper gastrointestinal pH and motility. Dig Dis Sci. 2011;56(6):1735–42.

    Article  CAS  PubMed  Google Scholar 

  13. Hara N et al. Prevention of virus-induced type 1 diabetes with antibiotic therapy. J Immunol. 2012;189(8):3805–14.

    Article  CAS  PubMed  Google Scholar 

  14. Markle JG et al. Sex differences in the gut microbiome drive hormone-dependent regulation of autoimmunity. Science. 2013;339(6132):1084–8.

    Article  CAS  PubMed  Google Scholar 

  15. Ewing B, Green P. Base-calling of automated sequencer traces using phred. II. Error probabilities. Genome Res. 1998;8(3):186–94.

    Article  CAS  PubMed  Google Scholar 

  16. Edgar RC et al. UCHIME improves sensitivity and speed of chimera detection. Bioinformatics. 2011;27(16):2194–200.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  17. Schloss PD, Westcott SL. Assessing and improving methods used in operational taxonomic unit-based approaches for 16S rRNA gene sequence analysis. Appl Environ Microbiol. 2011;77(10):3219–26.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  18. Pruesse E, Peplies J, Glockner FO. SINA: accurate high-throughput multiple sequence alignment of ribosomal RNA genes. Bioinformatics. 2012;28(14):1823–9. doi:10.1093/bioinformatics/bts252. Epub 2012 May 3.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  19. Pruesse E et al. SILVA: a comprehensive online resource for quality checked and aligned ribosomal RNA sequence data compatible with ARB. Nucleic Acids Res. 2007;35(21):7188–96.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  20. Robertson CE, et al. Explicet: graphical user interface software for metadata-driven management, analysis, and visualization of microbiome data. Bioinformatics. (in press), 2013.

  21. Magurran AE. Measuring biological diversity. Malden, USA: Blackwell; 2004.

    Google Scholar 

  22. Zhang H et al. Human gut microbiota in obesity and after gastric bypass. Proc Natl Acad Sci U S A. 2009;106(7):2365–70.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  23. Ward EK et al. Acid suppression medications delay peak weight loss after bariatric surgery. Gastroenterology. 2013;144(5, Supplement 1):S-270.

    Google Scholar 

Download references

Acknowledgments

This project was supported by a grant from the Colorado Clinical Translational Science Institute Project Grant (5UL1RR025780).

Conflict of Interest

No conflicts of interest exist for any of the authors.

Funding

No writing assistance was provided for this manuscript.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Gregory L. Austin.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ward, E.K., Schuster, D.P., Stowers, K.H. et al. The Effect of PPI Use on Human Gut Microbiota and Weight Loss in Patients Undergoing Laparoscopic Roux-en-Y Gastric Bypass. OBES SURG 24, 1567–1571 (2014). https://doi.org/10.1007/s11695-014-1275-1

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11695-014-1275-1

Keywords

Navigation