title: Long-term effect of Helicobacter pylori eradication on the reversibility of acid secretion in profound hypochlorhydria.
abstract: BACKGROUND
  Although profound hypochlorhydria is considered to be an important risk factor for development of gastric cancer, long-term effect of Helicobacter pylori eradication on its reversibility remains uncertain.
  
  
  OBJECTIVE
  To clarify the change in acid secretion after eradication in a long-term follow-up over 5 years in patients with profound hypochlorhydria.
  
  
  METHODS
  Twenty-three H. pylori-positive patients with hypochlorhydria (<0.6 mmol/10 min) were enrolled prospectively. Assessment of gastrin-stimulated acid output and histologic evaluation of biopsy specimens were performed prior to, and 1, 7 months after eradication. Subsequently, gastric acid secretion was assessed for long-term period over 5 years after eradication in 12 patients.
  
  
  RESULTS
  Gastric acid secretion was reversed to normal range in nine of 23 patients (39%) at 7 months after eradication. In the long-term follow-up, gradual and significant recovery in gastric acid secretion was observed up to 2 years post-therapy. However, there was no additional increase during the last 3 years of 5-year follow-up period, leaving the acid secretory levels subnormal in the majority of the patients.
  
  
  CONCLUSIONS
  This long-term follow-up study suggests that the pathologic process has already progressed to an irreversible stage in the majority of H. pylori-positive patients with marked body atrophy and profound hypochlorhydria.
authors.affiliation: Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan. jiijima@int3.med.tohoku.ac.jp
authors.forename: K
authors.initials: K
authors.lastname: Iijima
authors.forename: H
authors.initials: H
authors.lastname: Sekine
authors.forename: T
authors.initials: T
authors.lastname: Koike
authors.forename: A
authors.initials: A
authors.lastname: Imatani
authors.forename: S
authors.initials: S
authors.lastname: Ohara
authors.forename: T
authors.initials: T
authors.lastname: Shimosegawa
mesh_terms: D000126:Achlorhydria / Q000150:complications* / Q000378:metabolism; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000897:Anti-Ulcer Agents / Q000627:therapeutic use; D017291:Clarithromycin / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D005744:Gastric Acid / Q000378:metabolism*; D016481:Helicobacter Infections / Q000150:complications / Q000188:drug therapy*; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008795:Metronidazole / Q000627:therapeutic use; D008875:Middle Aged; D009853:Omeprazole / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D000897:Anti-Ulcer Agents; D008795:Metronidazole; D017291:Clarithromycin; D009853:Omeprazole