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Eur J Clin Invest 2011; 41 (4): 380–386

Background  Gastroesophageal reflux disease (GERD), including erosive reflux disease and non‐erosive reflux disease (NERD), is a chronic disease with a significant negative effect on quality of life. State‐of‐the‐art treatment involves proton pump inhibitors (PPIs). However, relapse of symptoms occurs in the majority of the patients who require recurrent or continuous therapy. Although PPIs are well tolerated, little information is available about gastrointestinal side effects.

Aim  To evaluate the effects of long‐term PPI treatment on development of bowel symptoms and/or small intestinal bacterial overgrowth (SIBO).

Methods  Patients with NERD not complaining of bowel symptoms were selected by upper endoscopy, 24‐h pH‐metry and a structured questionnaire concerning severity and frequency of bloating, flatulence, abdominal pain, diarrhoea and …