The effect of H2-receptor antagonist and proton pump inhibitor on microbial proliferation in the stomach.
OBJECTIVE
Intra-gastric bacterial proliferation is frequent in patients with hypochlohydria. However, status of gastric bacterial infection in patients receiving proton pump inhibitor or H2-receptor antagonist remains controversial. The purpose of this study was to investigate the microbial condition of the stomach in patients who received H2-receptor antagonist or proton pump inhibitor.


METHODS
Between November 2000 and January 2002, 102 patients were enrolled in this study. Of these, 52 did not receive any treatment (group I), 26 received H2-receptor antagonist (group II), and 24 received proton pump inhibitor (group III). Ten mL of gastric juice were aspirated for culture during endoscopic examination. The aerobic and anaerobic bacterial and fungal cultures were performed immediately. A glass pH meter measured the pH of the gastric juice.


RESULTS
The intra-gastric pH was 2.91+/-2.06 (mean +/- SD), 4.12+/-2.83, and 5.11+/-2.47 for groups I, II, and III, respectively (p=0.001 between groups I and III, p>0.05 between groups I and II, and groups II and III). The positive bacterial culture rates were 66.7% (16/24) in group III, 46.2% (12/26) in group II, and 28.8% (15/52) in group I (p=0.007 between groups III and I,p>0.05 between groups I and II, and groups II and III). The positive candidal culture rates were 12.5% (3/24) in group III, 11.5% (3/26) in group II, and 17.3% (9/52) in group I (p>0.05).


CONCLUSIONS
Patients who received proton pump inhibitor had more acid suppression and intra-gastric bacterial infection than those of the control group. The intra-gastric candidal infection was not related to intra-gastric pH or anti-secretory medication in this study.
Wang
Kun
K
Division of Gastroenterology, Department of Medicine, Cardinal Tien Hospital and School of Medicine Fu-Jen Catholic University, Taipei, Taiwan, ROC.
Lin
Hwai-Jeng
HJ
Perng
Chin-Lin
CL
Tseng
Guan-Ying
GY
Yu
Kwok-Woon
KW
Chang
Full-Young
FY
Lee
Shou-Dong
SD
D000328:Adult; D000368:Aged; D000897:Anti-Ulcer Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001419:Bacteria / Q000254:growth & development*; D002175:Candida / Q000254:growth & development*; D002927:Cimetidine / Q000009:adverse effects / Q000627:therapeutic use*; D015169:Colony Count, Microbial; D003114:Colony-Forming Units Assay; D005260:Female; D005745:Gastric Acidity Determination; D005750:Gastric Juice / Q000382:microbiology*; D005756:Gastritis / Q000188:drug therapy / Q000382:microbiology; D005773:Gastroscopy; D006635:Histamine H2 Antagonists / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009853:Omeprazole / Q000009:adverse effects / Q000627:therapeutic use*; D010437:Peptic Ulcer / Q000188:drug therapy / Q000382:microbiology; D054328:Proton Pump Inhibitors; D011899:Ranitidine / Q000009:adverse effects / Q000627:therapeutic use*; D012307:Risk Factors
D000897:Anti-Ulcer Agents; D006635:Histamine H2 Antagonists; D054328:Proton Pump Inhibitors; D002927:Cimetidine; D011899:Ranitidine; D009853:Omeprazole