Mixed
Use of proton pump inhibitors (PPIs) or genetic achlorhydria promotes the progression of alcoholic liver disease, non-alcoholic fatty liver disease (NAFLD), and non-alcoholic steatohepatitis (NASH) by inducing overgrowth and translocation of intestinal Enterococcus species to the liver.
If you have liver disease (alcoholic or fatty) and take acid-reflux medication like omeprazole, discuss with your doctor whether you still need it. This research shows these drugs can worsen liver damage by allowing harmful gut bacteria to reach the liver. Do not stop medication abruptly without medical advice, but be aware that long-term use may carry liver risks.
Here, we show that proton pump inhibitors promote progression of alcoholic liver disease, non-alcoholic fatty liver disease, and non-alcoholic steatohepatitis in mice by increasing numbers of intestinal Enterococcus spp. Translocating enterococci lead to hepatic inflammation and hepatocyte death.
Why this rating
Strong mechanistic evidence in mice (genetic and pharmacological models) supported by human cohort data showing increased risk.
Source
Gastric acid suppression promotes alcoholic liver disease by inducing overgrowth of intestinal Enterococcus
Cristina Llorente et al. · Nature Communications · 2017
DOI 10.1038/s41467-017-00796-x
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