Reflux Medication and Bacterial Overgrowth

by Jan Gambino Patient Expert

A recently published study found a link between taking Proton Pump Inhibitor (PPI) medication for Gastroesophageal Reflux Disease (GERD) and bacterial overgrowth.

PPI medication is better known by the brand names such as Nexium, Prilosec, Prevacid and Aciphex, among others. Small Intestinal Bacterial Overgrowth or SBIO occurs when a large amount of bacteria is found in the small intestine.
While bacteria is normally found in the small intestine, too much can lead to gas, diarrhea, abdominal pain and bloating. Long term SIBO can lead to weight loss and nutritional deficits.

In the study, adults using PPI medication for a long time to treat GERD were compared to a group of adults with Irritable Bowel Syndrome (IBS) and adults without GERD or IBS. Bacterial overgrowth was found in 50% of adults with GERD and
using PPI medication compared to 25% of adults with IBS (no GERD medication) and 6% of adults (no GERD, IBS or GERD medication). The researchers concluded that bacterial overgrowth was more common in adults using PPI medication for GERD than adults with IBS or those without either IBS or GERD.

If you are on PPI medication, what should you do? While PPI medication has a long history of providing strong acid reduction, pain relief and healing of ulcers/esophagitis, there are some known side effects. You and your doctor need to be aware of the benefits and side effects of PPI's (and all medications for that matter).

If you are on PPI medication and you are worried about bacterial overgrowth, what should you do?


Continue to Take Your Medication as Prescribed: It is important to continue taking your PPI medication. Bacterial overgrowth is highly treatable with antibiotics so you can continue to take your PPI medication if needed.


Discuss Your Symptoms: If you think you are having a problem or symptom as a result of taking PPI medication, tell your doctor. He/she will decide if your symptoms sound like bacterial overgrowth or something else. A breath test can be done in the office if needed.


Review GERD Treatment: You and the doctor need to review your GERD treatment plan every 6 to 12 months or sooner if needed. Make sure the PPI medication is still a necessary part of the treatment plan. Sometimes a different medication such as a H2 blocker is needed. Lifestyle and diet changes may allow you to decrease the need for medication or use medication on an "as needed" basis rather than daily.


Add Probiotics:
Ask your doctor if you should take probiotics to prevent bacterial overgrowth.

Jan Gambino
Meet Our Writer
Jan Gambino

Jan wrote for HealthCentral as a patient expert for Acid Reflux.