Evidence map›Paper›PMID 42198379›Full record

ReviewPharmaceuticals (Basel, Switzerland)2026

Rethinking Long-Term PPI Therapy in GERD: A Narrative Review from a Microbial Ecology Perspective Beyond Acid Suppression.

Andrea Zanoni, Sonia Facchin, Valentina Mari, Luisa Bertin, Edoardo Vincenzo Savarino

Abstract readReview
In one paragraph

Review in Pharmaceuticals (Basel, Switzerland), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Andrea ZanoniUnit of General Surgery, Rovereto Hospital Azienda Sanitaria Universitaria Integrata of Trento (ASUIT), 38068 Rovereto, Italy.ORCID 0000-0003-1259-0821
Sonia FacchinDepartment of Surgery, Oncology and Gastroenterology (DISCOG), University of Padua, 35128 Padua, Italy.ORCID 0000-0002-6774-590X
Valentina MariUnit of General Surgery, Rovereto Hospital Azienda Sanitaria Universitaria Integrata of Trento (ASUIT), 38068 Rovereto, Italy.
Luisa BertinDepartment of Surgery, Oncology and Gastroenterology (DISCOG), University of Padua, 35128 Padua, Italy.ORCID 0009-0001-9816-4171
Edoardo Vincenzo SavarinoDepartment of Surgery, Oncology and Gastroenterology (DISCOG), University of Padua, 35128 Padua, Italy.ORCID 0000-0002-3187-2894

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Gastroesophageal reflux disease (GERD) is a common chronic disorder of the upper gastrointestinal tract, traditionally explained by an acid-centric model in which gastric acid causes mucosal injury and symptoms. Proton pump inhibitors (PPIs) are the mainstay of therapy and effectively control symptoms in many patients. However, up to 50% of individuals remain symptomatic despite adequate acid suppression, suggesting that GERD is a multifactorial condition involving anti-reflux barrier dysfunction, impaired mucosal defense, immune activation, and alterations in the esophageal microbiota. This study is a narrative review aimed at evaluating current evidence on the interactions between acid suppression, esophageal microbial ecology, and host-microbe interactions in GERD, and at exploring the potential role of microbiota-targeted therapeutic strategies. The literature search was conducted using electronic databases (e.g., PubMed and Scopus), without formal time restrictions, prioritizing recent and clinically relevant studies. Evidence was qualitatively synthesized to provide an integrated overview. Recent studies suggest that the esophagus hosts a microbial ecosystem that may contribute to mucosal homeostasis. In GERD and Barrett's esophagus, several studies report a shift toward Gram-negative anaerobic bacteria with potential pro-inflammatory activity. Long-term PPI therapy has been associated with increased gastric pH and changes in gastrointestinal microbiota composition, including a relative increase in taxa such as

Indexed as

dysbiosisepithelial barrieresophageal microbiotaGERDprebioticsprobioticsproton pump inhibitors

Identifiers

PMID42198379
PMCPMC13210101

What Socratic holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.