UEG Week 2019

Arnau Vich Vila

Gerry Gajadharsingh writes:

“Clinicians are paying more attention to the use of probiotics in supporting the gut microbiome (and so are commercial companies, launching many different types of probiotics, all claiming to be better than others!). We have suspected for a while that drugs can affect the gut microbiome, as the research below is now confirming.

A new study presented at UEG Week 2019 has found that 18 commonly used drug categories extensively affect the taxonomic structure and metabolic potential of the gut microbiome, including PPI (proton pump inhibitors), antibiotics, laxatives and metformin, SSRI anti-depressants and steroids, giving the most problems.

Patients sometimes wonder why I suggest probiotics even if they don’t have gastro-intestinal symptoms, not sure if some of them really believe my explanation, hopefully this research will help.”

Commenting, lead-researcher Arnau Vich Vila said: “We already know that the efficiency and the toxicity of certain drugs are influenced by the bacterial composition of the gastrointestinal tract and that the gut microbiota has been related to multiple health conditions; therefore, it is crucial to understand which are the consequences of medication use in the gut microbiome. Our work highlights the importance of considering the role of the gut microbiota when designing treatments and also points to new hypotheses that could explain certain side-effects associated with medication use.”

Barcelona, October 23, 2019, A new study presented at UEG Week 2019 has found that 18 commonly used drug categories extensively affect the taxonomic structure and metabolic potential of the gut microbiome. Eight different categories of drugs were also found to increase antimicrobial resistance mechanisms in the study participants.

Researchers at the University Medical Center Groningen and the Maastricht University Medical Center looked at 41 commonly used drug categories and assessed 1883 faecal samples from a population-based cohort, patients with IBD and patients with IBS intermixed with healthy controls. The researchers compared the taxonomic and metabolic functions profiles of drug users to non-drug users, looking at the effect of single medication use and then combined medication use. The changes observed could increase the risk of intestinal infections, obesity and other serious conditions and disorders linked to the gut microbiome.

Gut microbiota is the microbe population living in the intestine. It contains tens of trillions of microorganisms, including at least 1000 different species of known bacteria. The human gut’s microbiota population is influenced by a number of different factors, including medication. The microbiome has received increasing attention over the last 15 years with numerous studies reporting changes in the gut microbiota during not only obesity, diabetes, and liver diseases but also cancer and neurodegenerative diseases.

The drug categories found to have the biggest impact on the microbiome include:

  • Proton pump inhibitors (PPIs) – used to treat dyspepsia which affects between 11% and 24% of the European population. PPIs are also used to treat peptic ulcer, H. Pylori eradication, Gastro reflux and Barrett’s oesophagus.
  • Metformin – used as a treatment for Type 2 diabetes, affecting 10% of European adults
  • Antibiotics – used to treat bacterial infections, taken by 34% of the European population each year
  • Laxatives – used to treat and prevent constipation, affecting 17% of European adults

The gut microbiota of PPI users showed increased abundance of upper gastrointestinal tract bacteria and increased fatty acid production, while metformin users had higher levels of the potentially harmful bacteria Escherichia coli (E. coli).

The researchers also found that an additional seven drug categories were associated with significant changes in bacterial populations in the gut. The use of certain antidepressants (called SSRIs) by those with IBS was associated with an abundance of the potentially harmful bacteria species Eubacterium ramulus. The use of oral steroids was associated with high levels of methanogenic bacteria which has been associated with obesity and an increase in BMI.

Commenting, lead-researcher Arnau Vich Vila said: “We already know that the efficiency and the toxicity of certain drugs are influenced by the bacterial composition of the gastrointestinal tract and that the gut microbiota has been related to multiple health conditions; therefore, it is crucial to understand which are the consequences of medication use in the gut microbiome. Our work highlights the importance of considering the role of the gut microbiota when designing treatments and also points to new hypotheses that could explain certain side-effects associated with medication use.”

UEG Week is the largest and most prestigious gastroenterology meeting in Europe and has developed into a global congress. It attracts over 14,000 participants each year, from more than 120 countries, and numbers are steadily rising. UEG Week provides a forum for basic and clinical scientists from across the globe to present their latest research in digestive and liver diseases, and also features a two-day postgraduate course that brings together top lecturers in their fields for a weekend of interactive learning.

About UEG

UEG, or United European Gastroenterology, is a professional non-profit organisation combining all the leading European medical specialist and national societies focusing on digestive health.