Eradicating Helicobacter pylori reduces hypergastrinaemia during long-term omeprazole treatment

A El-Nujumi, C Williams, J E Ardill, K Oien, K E L McColl

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Abstract

BACKGROUND: Both proton pump inhibitor drug treatment and Helicobacter pylori infection cause hypergastrinaemia in man.

AIMS: To determine whether eradicating H pylori is a means of reducing hypergastrinaemia during subsequent proton pump inhibitor treatment.

METHODS: Patients with H pylori were randomised to treatment with either anti-H pylori or symptomatic treatment. One month later, all received four weeks treatment with omeprazole 40 mg/day for one month followed by 20 mg/day for six months. Serum gastrin concentrations were measured before and following each treatment.

RESULTS: In the patients randomised to anti-H pylori treatment, eradication of the infection lowered median fasting gastrin by 48% and meal stimulated gastrin by 46%. When gastrin concentrations one month following anti-H pylori/symptomatic treatment were used as baseline, omeprazole treatment produced a similar percentage increase in serum gastrin in the H pylori infected and H pylori eradicated patients. Consequently, in the patients in which H pylori was not eradicated, median fasting gastrin concentration was 38 ng/l (range 26-86) at initial presentation and increased to 64 ng/l (range 29-271) after seven months omeprazole, representing a median increase of 68% (p < 0.005). In contrast, in the patients randomised to H pylori eradication, median fasting gastrin at initial presentation was 54 ng/l (range 17-226) and was unchanged after seven months omeprazole at 38 ng/l (range 17-95).

CONCLUSION: Eradicating H pylori is a means of reducing the rise in gastrin during subsequent long term omeprazole treatment. In view of the potential deleterious effects of hypergastrinaemia it may be appropriate to render patients H pylori negative prior to commencing long-term proton pump inhibitor treatment.

Original languageEnglish
Pages (from-to)159-65
Number of pages7
JournalGut
Volume42
Issue number2
Publication statusPublished - Feb 1998
Externally publishedYes

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Keywords

  • Adult
  • Alginates
  • Aluminum Hydroxide
  • Amoxicillin
  • Antacids
  • Anti-Ulcer Agents
  • Drug Combinations
  • Drug Therapy, Combination
  • Esophagitis
  • Female
  • Gastrins
  • Gastroscopy
  • Helicobacter Infections
  • Helicobacter pylori
  • Humans
  • Male
  • Metronidazole
  • Middle Aged
  • Omeprazole
  • Organometallic Compounds
  • Peptic Ulcer
  • Silicic Acid
  • Sodium Bicarbonate
  • Clinical Trial
  • Comparative Study
  • Journal Article
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

Cite this

El-Nujumi, A., Williams, C., Ardill, J. E., Oien, K., & McColl, K. E. L. (1998). Eradicating Helicobacter pylori reduces hypergastrinaemia during long-term omeprazole treatment. Gut, 42(2), 159-65.