Distribution of atrophy in Helicobacter pylori-infected subjects taking proton pump inhibitors.
BACKGROUND
Gastric atrophy is associated with Helicobacter pylori infection. Conflicting results have been obtained as to whether acid suppressant therapy hastens the development or changes the distribution of atrophy in the stomach. The aim of this study was to investigate whether concomitant proton pump inhibitor (PPI) therapy in H. pylori-infected individuals resulted in an increase or an alteration in atrophy distribution and whether this was reflected by the plasma gastrin.


METHODS
Multiple gastric biopsy specimens were taken from the antrum and corpus from 46 H. pylori-infected subjects, 18 of whom were taking PPIs, and assessed histologically by the updated Sydney System. The control group was age- and sex-matched to the index group. Fasting gastrin levels were measured.


RESULTS
In the control group there was no significant tendency for either antral or corpus atrophy to predominate (P = 0.44). In the treatment group there was a significant tendency for corpus as opposed to antral atrophy to develop (P < 0.001). There was no significant difference in the overall atrophy score between the treated and untreated groups (P = 0.76). Fasting gastrin levels were significantly higher in the treated group (P < 0.001).


CONCLUSIONS
Treatment with PPIs in H. pylori-infected subjects does not lead to an overall increase in gastric atrophy. It does, however, result in an increased prevalence of corpus as opposed to antral atrophy. This is associated with a significantly higher gastrin level.
Depts of Medicine, Royal Victoria Hospital, Belfast, N. Ireland.
C J
CJ
Larkin
Watson RGP
J M
JM
Sloan
M
M
Stevenson
J E
JE
Ardill
D
D
Buchanan
D000328:Adult; D000367:Age Factors; D000368:Aged; D001284:Atrophy / Q000473:pathology; D001707:Biopsy, Needle; D004791:Enzyme Inhibitors / Q000008:administration & dosage*; D005260:Female; D005755:Gastrins / Q000097:blood; D016481:Helicobacter Infections / Q000175:diagnosis / Q000188:drug therapy*; D016480:Helicobacter pylori / Q000187:drug effects* / Q000302:isolation & purification; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D054328:Proton Pump Inhibitors; D011863:Radioimmunoassay; D012016:Reference Values; D018709:Statistics, Nonparametric; D013270:Stomach / Q000187:drug effects* / Q000473:pathology*
D004791:Enzyme Inhibitors; D005755:Gastrins; D054328:Proton Pump Inhibitors