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Review
. 2021 May 29;9(6):617.
doi: 10.3390/biomedicines9060617.

Impact of Environmental and Pharmacologic Changes on the Upper Gastrointestinal Microbiome

Joshua Bilello  1 , Ikenna Okereke  2
Affiliations
Review

Impact of Environmental and Pharmacologic Changes on the Upper Gastrointestinal Microbiome

Joshua Bilello et al. Biomedicines. .

Abstract

Diseases of the upper gastrointestinal tract have become more prevalent over time. Mechanisms of disease formation are still only partially understood. Recent literature has shown that the surrounding microbiome affects the propensity for disease formation in various parts of the upper gastrointestinal tract. A review was performed of any literature to our best knowledge concerning the effects of pharmacologic agents, environmental changes, and surgical intervention on the microbiome of the upper gastrointestinal tract. Searches of the literature were performed using specific keywords related to drugs, surgical procedures, and environmental factors. Many prescription and nonprescription drugs that are commonly used have varying effects on the upper gastrointestinal tract. Proton pump inhibitors may affect the relative prevalence of some organisms in the lower esophagus and have less effect in the proximal esophagus. Changes in the esophageal microbiome correlate with some esophageal diseases. Drugs that induce weight loss have also been shown to affect the microbiomes of the esophagus and stomach. Common surgical procedures are associated with shifts in the microbial community in the gastrointestinal tract. Environmental factors have been shown to affect the microbiome in the upper gastrointestinal tract, as geographic differences correlate with alterations in the microbiome of the gastrointestinal tract. Understanding the association of environmental and pharmacologic changes on the microbiome of the upper gastrointestinal tract will facilitate treatment plans to reduce morbidity from disease.

Keywords: gastrointestinal tract; microbiome; proton pump inhibitors.

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Conflict of interest statement

All authors declare that they have no competing interests. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Figures

Figure 1
Figure 1
Relationship of (a) PPI dose and (b) PPI duration of use vs. normalized absolute levels of organism for Prevotella and Veillonella. There was no association between PPI dose or duration of use and organism level.
Figure 1
Figure 1
Relationship of (a) PPI dose and (b) PPI duration of use vs. normalized absolute levels of organism for Prevotella and Veillonella. There was no association between PPI dose or duration of use and organism level.
Figure 2
Figure 2
Effects of antibiotics on organism levels in various aspects of the upper gastrointestinal tract.
Figure 3
Figure 3
Effects of Roux-en-Y gastric bypass on organism levels in the stomach.
See this image and copyright information in PMC

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