Can omeprazole (proton pump inhibitor) cause diarrhea?

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Last updated: June 29, 2025View editorial policy

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From the FDA Drug Label

Omeprazole delayed-release capsules can cause serious side effects, including: • Diarrhea. Omeprazole delayed-release capsules may increase your risk of getting severe diarrhea. This diarrhea may be caused by an infection (Clostridium difficile) in your intestines.

Yes, omeprazole can cause diarrhea, including severe diarrhea that may be caused by an infection (Clostridium difficile) in the intestines 1.

From the Research

Yes, omeprazole can cause diarrhea as a side effect, as evidenced by a case report where a patient developed severe diarrhea after taking omeprazole, likely due to the accumulation of omeprazole metabolites resulting from its slow metabolism in vivo 2.

Omeprazole and Diarrhea

Omeprazole is a proton pump inhibitor (PPI) that reduces gastric acid secretion, and while most people tolerate it well, gastrointestinal disturbances including diarrhea, abdominal pain, and nausea are among the more common adverse effects.

  • The mechanism behind PPI-induced diarrhea may involve alterations in gut microbiota, as stomach acid normally helps regulate bacterial populations in the digestive tract.
  • When acid production is suppressed by omeprazole, changes in bacterial composition can occur, potentially leading to diarrhea.
  • Additionally, reduced acid may affect digestive enzyme activity and nutrient absorption.

Management of Omeprazole-Induced Diarrhea

If you experience persistent or severe diarrhea while taking omeprazole, you should consult your healthcare provider, as they may recommend:

  • Reducing the dose
  • Switching to a different PPI
  • Trying an alternative acid-reducing medication such as an H2 blocker (like famotidine) Never stop taking prescribed omeprazole suddenly without medical guidance.

Evidence from Studies

A study published in 2017 found that omeprazole treatment caused significant changes in stool culture results, with patients treated with a higher dose of omeprazole having a tendency towards decreased diversity of colonic microflora 3. Another study published in 1998 reported that diarrhea was one of the most commonly reported adverse events in patients taking omeprazole, along with headache, dizziness, flatulence, abdominal pain, and constipation 4.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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