Eradication of Helicobacter pylori in patients with duodenal ulcer lowers basal and peak acid outputs to gastrin releasing peptide and pentagastrin.
BACKGROUND
Patients with duodenal ulcer (DU) have high basal (BAO) and peak (PAO) acid outputs. The effect of Helicobacter pylori eradication on these variables is unclear.


OBJECTIVE
To discover if gastric acid hypersecretion in patients with DU is caused by H pylori.


METHODS
BAO, gastrin releasing peptide (GRP), and pentagastrin stimulated PAO in 10 H pylori negative controls, and in 10 H pylori positive patients with DU was measured before and six months after H pylori eradication. H pylori status was determined by histology, culture, and by the 13C-urea breath test. After collecting a 30 minute basal aspirate, GRP 40 pmol/kg/h was infused for 45 minutes, and after a 30 minute washout, pentagastrin 6 micrograms/kg was injected intramuscularly.


RESULTS
Basal and stimulated acid output (PAOGRP and PAOPg) were significantly higher in H pylori positive DU than in H pylori negative controls. Six months after H pylori eradication, basal and stimulated acid outputs were all significantly lower than before H pylori eradication.


CONCLUSIONS
This study has shown that BAO, PAOGRP, and PAOPg are higher in H pylori positive DU than in H pylori negative controls. All decreased significantly six months after H pylori eradication, to fall within the range of controls. These results are compatible with a hypothesis that acid hypersecretion in duodenal ulcer disease is caused by H pylori infection.
Harris
A W
AW
Parkside Helicobacter Study Group, Central Middlesex Hospital, London.
Gummett
P A
PA
Misiewicz
J J
JJ
Baron
J H
JH
D000328:Adult; D016022:Case-Control Studies; D004381:Duodenal Ulcer / Q000209:etiology / Q000378:metabolism*; D005260:Female; D005744:Gastric Acid / Q000378:metabolism*; D005750:Gastric Juice / Q000187:drug effects / Q000378:metabolism*; D019886:Gastrin-Releasing Peptide; D016481:Helicobacter Infections / Q000150:complications / Q000188:drug therapy / Q000378:metabolism*; D016480:Helicobacter pylori / Q000302:isolation & purification; D006801:Humans; D008297:Male; D008875:Middle Aged; D010418:Pentagastrin / Q000494:pharmacology*; D010455:Peptides / Q000494:pharmacology*
D010455:Peptides; D019886:Gastrin-Releasing Peptide; D010418:Pentagastrin