Country-wide medical records infer increased allergy risk of gastric acid inhibition

Nat Commun. 2019 Jul 30;10(1):3298. doi: 10.1038/s41467-019-10914-6.


Gastric acid suppression promotes allergy in mechanistic animal experiments and observational human studies, but whether gastric acid inhibitors increase allergy incidence at a population level remains uncharacterized. Here we aim to assess the use of anti-allergic medication following prescription of gastric acid inhibitors. We analyze data from health insurance records covering 97% of Austrian population between 2009 and 2013 on prescriptions of gastric acid inhibitors, anti-allergic drugs, or other commonly prescribed (lipid-modifying and antihypertensive) drugs as controls. Here we show that rate ratios for anti-allergic following gastric acid-inhibiting drug prescriptions are 1.96 (95%CI:1.95-1.97) and 3.07 (95%-CI:2.89-3.27) in an overall and regional Austrian dataset. These findings are more prominent in women and occur for all assessed gastric acid-inhibiting substances. Rate ratios increase from 1.47 (95%CI:1.45-1.49) in subjects <20 years, to 5.20 (95%-CI:5.15-5.25) in > 60 year olds. We report an epidemiologic relationship between gastric acid-suppression and development of allergic symptoms.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anti-Ulcer Agents / adverse effects*
  • Anti-Ulcer Agents / therapeutic use
  • Austria / epidemiology
  • Female
  • Gastric Acid / chemistry
  • Humans
  • Hypersensitivity / epidemiology*
  • Hypersensitivity / etiology
  • Hypersensitivity / immunology
  • Immune System / drug effects
  • Immune System / immunology
  • Incidence
  • Male
  • Medical Records / statistics & numerical data
  • Middle Aged
  • Proton Pump Inhibitors / adverse effects*
  • Proton Pump Inhibitors / therapeutic use
  • Young Adult


  • Anti-Ulcer Agents
  • Proton Pump Inhibitors