Proton pump inhibitors, H2 blocker use, and risk of inflammatory bowel disease in children

Naomi R.M. Schwartz, Susan Hutfless, Lisa J. Herrinton, Laura B. Amsden, Helene B. Fevrier, Matthew Giefer, Dale Lee, David L. Suskind, Joseph A.C. Delaney, Amanda I. Phipps

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

OBJECTIVES Evidence suggests use of proton pump inhibitors (PPIs) and H2 blockers may provoke disease flares in individuals with established inflammatory bowel disease (IBD); however, there are no studies investigating the relationship of these medications with risk of developing pediatric IBD. The hypothesis was that use of acid suppression therapy in children might be associated with development of pediatric IBD. METHODS This was a nested case-control study of 285 Kaiser Permanente Northern California members, age ≤21 years diagnosed with IBD from 1996 to 2016. Four controls without IBD were matched to each case on age, race, and membership status at the case’s index date. Disease risk scores (DRS) were computed for each subject. Odds ratios and 95% confidence intervals were calculated by using conditional logistic regression models adjusted for DRS. RESULTS The children’s mean age was 15.1 ± 2.6 years and 49.5% were female. Six cases (n = 3 Crohn's disease [CD], n = 3 ulcerative colitis [UC]) and 6 controls were prescribed PPIs and 10 cases (n = 7 CD, n = 3 UC) and 28 controls were prescribed H2 blockers. The OR for the association of at least 1 PPI or H2 blocker prescription with subsequent IBD was 3.6 (95% CI, 1.1–11.7) for PPIs and 1.6 (95% CI, 0.7–3.7) for H2 blockers. CONCLUSIONS Early-life PPI use appears to be associated with subsequent IBD risk. These findings have implications for clinical treatment of children with gastrointestinal symptoms and warrant further investigation in a larger cohort.

Original languageEnglish (US)
Pages (from-to)489-496
Number of pages8
JournalJournal of Pediatric Pharmacology and Therapeutics
Volume24
Issue number6
DOIs
StatePublished - Nov 1 2019

Keywords

  • Child
  • Epidemiology
  • Inflammatory bowel disease
  • Pharmacoepidemiology

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Pharmacology (medical)

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