Fig. 5

Influence of PPIs on the gut microbiome. A normal gut environment consists of considerable biodiversity, an intact gastric acid barrier and a non-inflammatory environment. PPIs can lead to gut dysbiosis, reduced biodiversity, a proinflammatory climate, and disruption of the gastric acid barrier, leading to infections and vitamin and mineral deficiency. This can, for example, lead to migraine episodes. Other possible consequences can be obesity, metabolic syndrome, systemic low-grade inflammation, which is also more common in obese individuals, and mood disturbances. All of these are also very commonly associated with migraine and migraine episodes