Proton pump inhibitor use is associated with an increased risk for microscopic colitis: a case-control study

Daniel Keszthelyi (1) , Sita V Jansen (1) , Gerben A Schouten (1) , Sander de Kort (1) , Brian Scholtes (2) , Leopold Gjb Engels (2) , Ad A. Masclee (1)

1 Gastroenterology and Hepatology
2 Internal Medicine

Background: Microscopic colitis (MC) causes chronic watery diarrhea. Recent studies have suggested an etiological role for various medications, including proton pump inhibitors, in the pathogenesis of MC. Aim: To determine whether an association exists between microscopic colitis and proton pump inhibitor use in patients with documented microscopic colitis versus age and sex-matched controls. Methods: In this retrospective case-control study. Cases of microscopic colitis from a secondary and tertiary referral medical center diagnosed in the last 5 years were reviewed. Demographic characteristics, clinical, histological and endoscopic records, as well as exposure to PPIs and NSAIDs were assessed. Controls from the population were matched to cases by gender and by age. Results: During the investigated period, 136 cases were identified in both hospitals. Of these, 95 cases of MC were retrieved for detailed analysis. Exposure to proton pump inhibitors at the time of the histological diagnosis was significantly higher in MC patients than in controls (38% vs 11%, p<0.001; adjusted OR of 4.5 [95% CI 2.0-9.5]). Conclusion: This observation confirms the presumed association between microscopic colitis and PPI use and supports the possible etiological role of PPI exposure in the development of microscopic colitis.

Mots clés: Medicine

Daniel Keszthelyi, Sita V Jansen, Gerben A Schouten, Sander de Kort, Brian Scholtes, et al.. Proton pump inhibitor use is associated with an increased risk for microscopic colitis: a case-control study. Alimentary Pharmacology and Therapeutics, 2010, 32 (9), pp.1124. ⟨10.1111/j.1365-2036.2010.04453.x⟩. ⟨hal-00576167⟩