Review article: the development of atrophic gastritis--Helicobacter pylori and the effects of acid suppressive therapy.
Helicobacter pylori is uniquely adapted to survival in the strongly acidic gastric lumen. In vitro, both acid and certain acid suppressors affect bacterial growth. In vivo, there is little evidence that acid suppressors have any effect on bacterial survival. In contrast, decrease of acid secretion quickly leads to a spreading of the bacterial infection throughout the body and fundus of the stomach, which is accompanied by an increase of the associated gastritis. Helicobacter pylori gastritis may, in a substantial number of infected subjects, ultimately lead to atrophy and intestinal metaplasia, conditions with an increased risk for gastric cancer. This review summarizes the data on the interrelation between Helicobacter pylori, gastric acid secretion and development of atrophic gastritis.
Department of Gastroenterology, Free University Hospital, Amsterdam, The Netherlands.
E J
EJ
Kuipers
A
A
Lee
E C
EC
Klinkenberg-Knol
S G
SG
Meuwissen
D000818:Animals; D000897:Anti-Ulcer Agents / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D005500:Follow-Up Studies; D005750:Gastric Juice / Q000378:metabolism; D005757:Gastritis, Atrophic / Q000453:epidemiology* / Q000209:etiology*; D016481:Helicobacter Infections / Q000150:complications* / Q000188:drug therapy; D016480:Helicobacter pylori / Q000187:drug effects; D006801:Humans; D009853:Omeprazole / Q000009:adverse effects / Q000627:therapeutic use; D012636:Secretory Rate / Q000187:drug effects; D014628:Vagotomy / Q000009:adverse effects
D000897:Anti-Ulcer Agents; D009853:Omeprazole