Does eradication of Helicobacter pylori infection reduce hypergastrinema during long term therapy with proton pump inhibitors?
OBJECTIVE
Proton pump inhibitors and Helicobacter pylori infection are the major cause of hypergastrinemia. In this study the effect of eradication therapy on blood gastrin levels in patients using long term proton pump inhibitors was evaluated.


METHODS
Twenty-seven Helicobacter pylori (positive) patients were included in the study, of whom 20 were given eradication treatment for seven days consisting of ranitidine bismuth citrate, clarithromycin and amoxicillin (eradication therapy group) and seven were given symptomatic therapy (symptomatic therapy group). Four patients who remanied Helicobacter pylori (positive) after eradication therapy were later added to the symptomatic therapy group. Lansoprazole 30 mg/day was then given to both the eradication therapy (n: 16) and the symptomatic therapy groups (n: 11) for the following three months. Fasting and non-fasting blood gastrin levels were measured initially then at one and four months after treatment.


RESULTS
Fasting gastrin levels were 49 % higher in the fourth month than in the first month (p<0.01) and 51 % higher than the initial level (p<0.01) in the symptomatic therapy group. There were no statistical differences between the initial, first month and fourth month non-fasting blood gastrin levels in the symptomatic therapy group (p>0.05). Fasting gastrin levels were 47 % higher in the fourth month than the first month (p<0.001) and 18 % lower than the initial level (p<0.05) in the eradication therapy group. Non-fasting gastrin levels were 4% higher in the fourth month than in the first month (p>0.05) and 34 % lower than the initial level (p< 0.05) in the eradication therapy group.


CONCLUSIONS
It is suggested that patients receiving long term proton pump inhibitor treatment should be evaluated for Helicobacter pylori positivity and treatment of this infection would be an appropriate approach to avoid hypergastrinemia.
Gürbüz
Ahmet K
AK
Gülhane Military Medical Academy, Haydarpasa Training Hospital, Department of Gastroenterology. hmetgurbuz2002@yahoo.com
Küçükkardali
Yaşar
Y
Yazgan
Yusuf
Y
Ozel
Melih
M
Polat
Taner
T