Author(s): Pereira SP, Gainsborough N, Dowling RH, Pereira SP, Gainsborough N, Dowling RH, Pereira SP, Gainsborough N, Dowling RH, Pereira SP, Gainsborough N, Dowling RH
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Abstract BACKGROUND: Small bowel bacterial overgrowth secondary to drug-induced hypochlorhydria may be of particular importance in the elderly, in whom anti-ulcer drugs are commonly prescribed and the consequences of malabsorption may be severe. METHODS: Duodenal aspirates were obtained from elderly individuals before (n = 24) and during a 2-month treatment course with either omeprazole (20 mg daily; n = 8) or ranitidine (300 mg b.d.; n = 6), and from six patients with small bowel bacterial overgrowth who had diarrhoea and malabsorption. RESULTS: Before treatment, duodenal bacterial counts were normal (< 10(4) colony forming units/mL) in 23 elderly subjects (96\%). However, six of 14 patients (43\%) treated with omeprazole (5 of 8) or ranitidine (1 of 6) developed bacterial counts > 10(5) cfu/mL. All remained asymptomatic and had normal lactulose breath H2 profiles during treatment. CONCLUSION: Drug-induced hypochlorhydria causes high duodenal bacterial counts in the elderly but, in the short term, this bacterial overgrowth is not associated with malabsorption.
This article was published in Aliment Pharmacol Ther
and referenced in Journal of Health & Medical Informatics