Patients with gastroesophageal reflux disease (GERD) or acid reflux disease that have common signs and symptoms such as feeling burning and painful in their esophagus, digestion problems, difficulty in swallowing, some nausea and pain in chest, too much salivation, and other complication from injury of esophagus (such as asthma, extreme cough and some others) often used Proton Pump Inhibitors (PPI) as their treatment and medications for long period.

But did they know the side effect of long term use of PPI?

Recent study from long-term usage of Proton Pump Inhibitors will contribute to overgrowth of bacterial in small intestinal.
All those bacterial in that condition will producing bloating, diarrhea and adverse events.

Dr. Luci Lombardo from the Mauriziano U.I Hospital, Torino, Italia, said, “The rationale for using IBS as ‘pathologic’ control stands on the large prevalence of small intestinal bacterial overgrowth in IBS patients and the overlapping of symptoms between two clinical conditions.”

The study involved 450 consecutive patients using glucose hydrogen breath test to see bacterial overgrowth in their small intestinal.

Of 450 patients enrolled in 3 groups:
- 200 gerd patients for median of 3 years treated with PPI
- 200 gerd patients with irritable bowel syndrome for at least 3 years did not PPI
- 50 healthy control who didn’t used for at least 10 years not used PPI

The result founded related to bacterial overgrowth in their small intestinal:
- 50% for gerd patients that used PPI
- 24.5% for gerd patients with Irritable bowel syndrome that did not use PPI
- 6% for only healthy control that didn’t used PPI

The lead author concluded while the glucose hydrogen breath test only indirectly detects the condition, it is noninvasive and reproducible, whereas the current standard; aspiration of duodenal (jejunal content for culture), is not.