Approximately 10 percent of the general population take a proton pump inhibitor PPI drug to block stomach acid secretions and relieve symptoms of frequent heartburn, acid reflux and gastroesophageal reflux disease. That percentage can be as much as seven times higher for people with chronic liver disease.
Researchers at University of California San Diego School of Medicine have discovered evidence in mice and humans that stomach gastric acid suppression alters specific gut bacteria in a way that promotes liver injury and progression of three types of chronic liver disease. The study is published October 10 in Nature Communications. We found that the absence of gastric acid promotes growth of Enterococcus bacteria in the intestines and translocation to the liver, where they exacerbate inflammation and worsen chronic liver disease.
Liver cirrhosis is the 12th leading cause of death worldwide and the number of people with chronic liver disease is increasing rapidly in Western countries.
Approximately half of all cirrhosis-associated deaths are related to alcohol. PPIs, which include brand names such as Prilosec, Nexium and Prevacid, are among the most commonly prescribed medications in the world, particularly among people with chronic liver disease.
The researchers found that mice with gastric acid suppression developed alterations in their gut microbiomes. Specifically, they had more Enterococcus species of bacteria. These changes promoted liver inflammation and liver injury, increasing the progression of all three types of liver disease in the mice: alcohol-induced liver disease, NAFLD and NASH.
In mice, some common acid reflux medications promote growth of Enterococcus bacteria like those shown here artificially glowing red in a petri dish in the intestines. Through a series of experiments in mice and humans, the team from University of California San Diego School of Medicine found that the absence of gastric acid promotes the growth of Enterococcus bacteria in the intestine. The bacteria can then move to the liver, where they exacerbate inflammation and worsen chronic liver disease, the researchers said.
In mouse models that mimic human alcoholic liver disease, the researchers used either genetic engineering or a PPI to block gastric acid production, then analysed stool samples to look at the gut microbiome. The liver breaks down omeprazole into products that can easily be removed from the body by the kidneys 1. Exposure of the liver to omeprazole may cause damage to liver cells leading to the inflammation of the liver 1. According to Netdoctor. Omeprazole use should be discontinued to allow the liver to heal 1.
According to the National Institutes of Health, the biliary system includes the liver, gallbladder, bile ducts inside the liver, and bile ducts outside the liver 2.
The biliary system is important in the production of bile, which is a liquid important in the digestion of fats and lips 2. Omeprazole impairs the normal flow of bile and leads this leads to yellowing of the eyes and skin, biliary pain, gall bladder pain, gall bladder inflammation and bile stones 1. Liver failure is the inability of the liver to perform its metabolic functions.
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