In this short presentation, Dr. David Perlmutter warns that proton pump inhibitors (PPIs), widely marketed and available over‑the‑counter as acid‑blocking drugs, alter stomach and intestinal pH, which in turn disrupts the gut microbiome. He explains that gut bacteria are crucial for health, mood, and appetite regulation, and that changes in the microbiome are linked to serious infections such as Clostridium difficile (C. diff). Citing a study published in the Canadian Journal of Medicine, he notes that hospitalized patients prescribed PPIs have roughly double the risk of developing a potentially fatal C. diff infection, a risk previously associated mainly with antibiotics. Dr. Perlmutter concludes by urging consumers to be cautious about routine PPI use, emphasizing that the downsides—particularly microbiome disruption and infection risk—are often downplayed in advertising.
Chapters
Hi everyone, Dr. David Perlmutter here, and welcome to The Empowered Neurologist. Today I would like to talk about these proton pump inhibiting drugs that everybody seems to think they need to take. These are the acid blocking drugs that we see advertised on the television, that when people are trying to eat some terrible food, if you take the acid blocking drug, well then everything seems to be okay. And we see these drugs are available widely, not just by prescription, but over the counter as well. And I think, to be fair, I'd like to offer up just another view on these drugs so that people are a little bit more informed. It turns out that acid-blocking drugs do, as you would expect, change the pH, change the acidity of the gut. And we all feel, for whatever reason, that we've got to reduce Stomach acid. Well, let's leave that alone for just a moment, but recognize that living within our intestines are our gut bacteria that play really important roles in determining our health, our resistance to disease, even our mood, and even helping to regulate our appetite. And when we change the pH, when we change the environment of our gastrointestinal system, we change the makeup of our intestinal bacteria. Now, what we've learned over the years is that this diarrhea illness called C. difficile or Clostridium difficile that may kill 30,000 to 45,000 Americans each year is strongly associated with changes in the gut bacteria. For example, it's strongly associated with taking antibiotics. But a new study from the Canadian Journal of Medicine talks about how when the gut bacteria are changed by taking these proton pump inhibitors, it will increase the risk of C. diff infection as well. So the study looks at hospitalized individuals who receive proton pump inhibitors and looks at their risk for developing C. diff, a potentially fatal diarrheal illness, and finds that in those individuals who were prescribed the proton pump inhibitors, their risk doubles. And the authors conclude that the changes that take place in the gut bacteria because of the changes in the pH or acidity of the GI system may well be responsible for the increased risk of developing C. diff. So the conclusion from my perspective is, again, beware that there are downsides to these miracle drugs that people seem to think that they want to take. We seem to think we need these drugs based upon advertisements, for example. And I think it's really important, a caveat emptor, let the buyer beware, to understand that there are potential downsides and that some of these downside risks, as they relate to this particular class of drugs, are related to changes in the gut bacteria. So it's important information. I'm Dr. David Perlmutter. Thanks for joining me.
