Does taking omeprazole increase the risk of foodborne illness from undercooked chicken by lowering stomach acid?

Yes, taking omeprazole (a proton pump inhibitor, or PPI) can modestly increase the risk of certain foodborne gastrointestinal infections, including those linked to undercooked chicken, because it lowers stomach acid and makes it easier for some bacteria to survive and reach the intestines. ^[1] Lower stomach acidity increases bacterial counts in the gastrointestinal tract, and PPI treatment has been associated with a slightly higher risk of infections such as Salmonella and Campylobacter, which are common pathogens in poultry. ^[2] This effect is considered small to moderate for most healthy people, but the risk can be more relevant if other factors are present (for example, recent antibiotic use or hospitalization). ^[3]

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How stomach acid protects you

Stomach acid is a key early defense against ingested germs: it kills or weakens many bacteria before they pass into the intestines. When acid is suppressed by PPIs, more bacteria survive the stomach’s acidic barrier. ^[4] As a result, pathogens like Salmonella and Campylobacter may be more likely to cause illness after exposure (for example, from undercooked chicken or cross‑contamination). ^[5]

A comprehensive review of published studies found that PPI use increases susceptibility to several enteric bacterial pathogens, with evidence strongest for Salmonella and Campylobacter; the magnitude of risk varied across studies but consistently pointed upward compared to non‑users. ^[6] The same review discussed multiple mechanisms higher gastric pH, altered gut flora, and changes in immune responses that likely contribute to increased vulnerability to these infections. ^[7]

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What the evidence says

• Regulatory drug information notes that PPIs decrease gastric acidity and may lead to a slight increase in gastrointestinal infections such as Salmonella and Campylobacter. ^[1] These statements are based on observed associations and biological plausibility rather than a guarantee that infection will occur. ^[2]

• Systematic review data report increased susceptibility to enteric infections in PPI users, particularly for Salmonella and Campylobacter, aligning with what’s known about acid suppression and pathogen survival. ^[6] Mechanistically, PPIs raise gastric pH, favor bacterial survival, and may enable more bacteria to reach the intestines intact. ^[7]

• Laboratory insights support the concept that acid conditions impact bacterial survival, and alterations in acid dynamics by PPIs change the stomach environment in a way that can favor pathogen passage. ^[8] PPIs require acid activation and act on the gastric proton pump, leading to sustained acid suppression that can extend protection against acid‑related disease but concurrently reduce acid‑mediated microbial killing. ^[9]

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Practical risk for undercooked chicken

Campylobacter and Salmonella are two of the most common causes of foodborne illness linked to poultry. While PPIs do not cause these infections, they can make illness more likely after exposure by lowering stomach acid. ^[1] For most otherwise healthy adults, the increase is described as “slight,” but it is clinically meaningful enough to advise extra care with food safety. ^[2] People with recent antibiotic use, hospitalization, or other health issues may experience a more noticeable risk. ^[6]

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How to reduce your risk

Even if you take omeprazole, you can significantly lower your chances of foodborne illness with consistent food‑safety practices:

• Cook chicken thoroughly to an internal temperature of 165°F (74°C); use a food thermometer rather than relying on color or texture. Proper cooking reliably kills Campylobacter and Salmonella. ^[1]
• Avoid cross‑contamination: keep raw poultry and its juices away from ready‑to‑eat foods; use separate cutting boards and utensils for raw meats.
• Wash hands with soap and water after handling raw chicken and before touching other foods.
• Refrigerate promptly; avoid the “danger zone” (40–140°F or 4–60°C) where bacteria multiply quickly.
• Be cautious with undercooked preparations (for example, pink or rare chicken, or improperly reheated leftovers), especially while taking a PPI.

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Should you stop omeprazole?

Omeprazole is effective for acid‑related conditions (like GERD, ulcers) and often necessary; the infection risk is typically small compared with the benefits of symptom control and healing. If you have ongoing concerns or frequent gastrointestinal infections, it can be reasonable to reassess the dose, duration, or necessity of the PPI with your clinician. ^[9] Sometimes stepping down therapy, optimizing timing and dosing, or considering alternative strategies is appropriate depending on your diagnosis and symptom severity. ^[8]

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Key takeaways

• Omeprazole lowers stomach acid, which can increase survival of ingested bacteria and modestly raise the risk of infections like Salmonella and Campylobacter associated with undercooked chicken. ^[1]
• The overall increase in risk is described as slight, but it’s more relevant if other risk factors exist. ^[2]
• Good food safety habits especially fully cooking poultry and preventing cross‑contamination greatly reduce the risk, whether or not you use PPIs. ^[3]

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Quick reference table

Topic	What to know	Why it matters
Acid suppression by PPIs	Lowers stomach acidity and increases bacterial survival through the stomach	More pathogens can reach the intestines alive, raising infection risk slightly [1]
Pathogens of concern in poultry	Salmonella, Campylobacter	These are common in undercooked chicken and linked to gastroenteritis [2]
Evidence summary	Slight but real association between PPI use and GI infections	Observed across regulatory information and systematic reviews [1] [6]
Risk modifiers	Hospitalization, antibiotics, comorbidities	These can add to the infection susceptibility seen with PPIs [6]
Prevention	Cook to 165°F (74°C), avoid cross‑contamination, hand hygiene	Correct cooking neutralizes the risk even if stomach acid is low [1]

If you’d like to discuss how to balance your acid‑related symptoms with foodborne illness prevention, I’m here to help.