Proton pump inhibitors (PPIs) and NSAIDs are among the most commonly used classes of drugs, with the former frequently co-prescribed to reduce gastro-duodenal injury caused by the latter. However, suppression of gastric acid secretion by PPIs is unlikely to provide any protection against the damage caused by NSAIDs in the more distal small intestine. As shown here, PPIs exacerbate NSAID-induced intestinal damage at least in part because of significant shifts in enteric microbial populations. Prevention or reversal of this dysbiosis may be a viable option for reducing the incidence and severity of NSAID enteropathy.
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