[Changes in Helicobacter pylori gastritis caused by therapy with inhibitors of gastric acid secretion].
In patients with Helicobacter pylori (Hp) gastritis long-term treatment with omeprazole leads to a worsening of the corpus gastritis. In the present overview we have analyzed the literature and our own studies to determine whether this also applies to other proton pump inhibitors (PPI), H2-receptor antagonists (H2-RA) and antacids.


RESULTS
Every antisecretory therapy--vagotomy, antacids, H2-RA and PPI--in patients with Hp gastritis leads to a worsening of the following parameters: Grade of gastritis, activity of gastritis, grade of replacement of foveolar epithelium by regenerative epithelium and grade of mucus depletion. The incidence of intestinal metaplasia does not increase. Atrophic gastritis has not been observed after one year of treatment; after five years of treatment with PPI, development of atrophy is uncertain. In the antrum treatment with PPI, but not with antacids or H2-RA, leads to an improvement in the gastritis parameters. The question whether the aggravation of corpus gastritis under antisecretory treatment might be detrimental over the long-term, whether, for example, the more pronounced gastritis might increase the risk of a subsequent carcinoma, remains to be clarified by long-term studies.
Stolte
M
M
Institut für Pathologie, Klinikum Bayreuth.
Meining
A
A
D000863:Antacids / Q000009:adverse effects* / Q000627:therapeutic use; D000897:Anti-Ulcer Agents / Q000009:adverse effects* / Q000627:therapeutic use; D005753:Gastric Mucosa / Q000187:drug effects / Q000473:pathology; D005756:Gastritis / Q000139:chemically induced / Q000188:drug therapy* / Q000473:pathology; D016481:Helicobacter Infections / Q000188:drug therapy* / Q000473:pathology; D016480:Helicobacter pylori / Q000187:drug effects; D006635:Histamine H2 Antagonists / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D008134:Long-Term Care; D054328:Proton Pump Inhibitors
D000863:Antacids; D000897:Anti-Ulcer Agents; D006635:Histamine H2 Antagonists; D054328:Proton Pump Inhibitors