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We read with great interest the article by Cheung et al 1 reporting long-term exposure to proton pump inhibitors (PPIs) following Helicobacter pylori (HP) eradication associated with increased risk of gastric cancer. PPIs are widely used worldwide to treat gastro-oesophageal reflux disorder, peptic ulcer and HP, but multiple reports have found they got some negative effects, such as increasing risk of the intra-abdominal infection, like spontaneous bacterial peritonitis,2 pseudomembranous colitis,3 liver abscess4 and affecting the gut microbiome.5 6 PPIs may theoretically increase risk of gaining acute cholecystitis due to the increasing the number of enteric organisms and risk of secondary infection; however, few reports have supported this hypothesis. Thus, we conducted a nationwide population-based case–control study to analyse the relationship between PPI exposure and …
Contributors S-CC: study conception and design and initial draft of manuscript; C-CL: data analysis and interpretation and initial draft of manuscript; C-YP, W-HH. S-WP, S-WL: concept of the study; H-CL: interpretation and manuscript draft and revision and guarantor of the article.
Funding This study was supported in part by the National Sciences Council, Executive Yuan (grant number NSC 99-2621-M-039-001), China Medical University Hospital (grant number 1MS1), Taiwan Ministry of Health and Welfare Clinical Trial Center (grant number MOHW106-TDU-B-212-113004).
Disclaimer This study is based on data from the National Health Insurance Research Database provided by the Bureau of National Health Insurance, Department of Health, Taiwan and managed by the National Health Research Institutes. The interpretations and conclusions contained herein do not represent the opinion of these agencies and institutions.
Competing interests None declared.
Provenance and peer review Not commissioned; internally peer reviewed.