Helicobacter pylori infection and chronic gastric acid hyposecretion

Emad M El-Omar, Karin Oien, Adil El-Nujumi, Derek Gillen, Angela Wirz, Stephen Dahill, Craig Williams, Joy E.S Ardill, Kenneth E.L McColl

Research output: Contribution to journalArticle

Abstract

BACKGROUND & AIMS: We have identified a subgroup of Helicobacter pylori-infected subjects with low or absent gastric acid output. The aim of this study was to document the morphological and functional abnormalities in these subjects and to assess the effect of eradicating the infection.

METHODS: The 16 hypochlorhydric subjects (6 men) had a mean age of 55 years (range, 36-79 years). They underwent a 14C-urea breath test, H. pylori serology, fasting gastrin, gastric autoantibodies, gastroscopy with antral and body biopsies, and measurement of peak acid output to pentagastrin (PAO(PG)). Their histology was compared with that of age- and sex-matched duodenal ulcer and nonulcer dyspepsia patients (16 each). H. pylori infection was eradicated in the hypochlorhydric subjects, and the investigations were repeated 6 months later.

RESULTS: Compared with controls, the hypochlorhydric subjects had less dense H. pylori colonization, body-predominant colonization and gastritis, and increased prevalence of body atrophy and intestinal metaplasia. Median PAO(PG) before eradication in the hypochlorhydric subjects was 1.1 mmol/h and increased to 12.6 mmol/h after eradication (P < 0.001), with no significant change in body atrophy or intestinal metaplasia.

CONCLUSIONS: In some subjects, chronic H. pylori infection produces a body-predominant gastritis and profound suppression of gastric acid secretion that is partially reversible with eradication therapy.

Original languageEnglish
Pages (from-to)15-24
Number of pages10
JournalGastroenterology
Volume113
Issue number1
Publication statusPublished - Jul 1997
Externally publishedYes

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Gastric Acid
Helicobacter Infections
Helicobacter pylori
Pentagastrin
Metaplasia
Gastritis
Atrophy
Gastroscopy
Breath Tests
Acids
Dyspepsia
Gastrins
Serology
Duodenal Ulcer
Autoantibodies
Urea
Fasting
Stomach
Histology
Biopsy

Keywords

  • Achlorhydria
  • Biopsy
  • Case-Control Studies
  • Female
  • Gastric Acid
  • Gastric Mucosa
  • Gastritis, Atrophic
  • Helicobacter Infections
  • Helicobacter pylori
  • Humans
  • Male
  • Middle Aged
  • Journal Article
  • Research Support, Non-U.S. Gov't

Cite this

El-Omar, E. M., Oien, K., El-Nujumi, A., Gillen, D., Wirz, A., Dahill, S., ... McColl, K. E. L. (1997). Helicobacter pylori infection and chronic gastric acid hyposecretion. Gastroenterology, 113(1), 15-24.
El-Omar, Emad M ; Oien, Karin ; El-Nujumi, Adil ; Gillen, Derek ; Wirz, Angela ; Dahill, Stephen ; Williams, Craig ; Ardill, Joy E.S ; McColl, Kenneth E.L. / Helicobacter pylori infection and chronic gastric acid hyposecretion. In: Gastroenterology. 1997 ; Vol. 113, No. 1. pp. 15-24.
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El-Omar, EM, Oien, K, El-Nujumi, A, Gillen, D, Wirz, A, Dahill, S, Williams, C, Ardill, JES & McColl, KEL 1997, 'Helicobacter pylori infection and chronic gastric acid hyposecretion', Gastroenterology, vol. 113, no. 1, pp. 15-24.

Helicobacter pylori infection and chronic gastric acid hyposecretion. / El-Omar, Emad M; Oien, Karin; El-Nujumi, Adil; Gillen, Derek; Wirz, Angela; Dahill, Stephen; Williams, Craig; Ardill, Joy E.S; McColl, Kenneth E.L.

In: Gastroenterology, Vol. 113, No. 1, 07.1997, p. 15-24.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Helicobacter pylori infection and chronic gastric acid hyposecretion

AU - El-Omar, Emad M

AU - Oien, Karin

AU - El-Nujumi, Adil

AU - Gillen, Derek

AU - Wirz, Angela

AU - Dahill, Stephen

AU - Williams, Craig

AU - Ardill, Joy E.S

AU - McColl, Kenneth E.L

PY - 1997/7

Y1 - 1997/7

N2 - BACKGROUND & AIMS: We have identified a subgroup of Helicobacter pylori-infected subjects with low or absent gastric acid output. The aim of this study was to document the morphological and functional abnormalities in these subjects and to assess the effect of eradicating the infection.METHODS: The 16 hypochlorhydric subjects (6 men) had a mean age of 55 years (range, 36-79 years). They underwent a 14C-urea breath test, H. pylori serology, fasting gastrin, gastric autoantibodies, gastroscopy with antral and body biopsies, and measurement of peak acid output to pentagastrin (PAO(PG)). Their histology was compared with that of age- and sex-matched duodenal ulcer and nonulcer dyspepsia patients (16 each). H. pylori infection was eradicated in the hypochlorhydric subjects, and the investigations were repeated 6 months later.RESULTS: Compared with controls, the hypochlorhydric subjects had less dense H. pylori colonization, body-predominant colonization and gastritis, and increased prevalence of body atrophy and intestinal metaplasia. Median PAO(PG) before eradication in the hypochlorhydric subjects was 1.1 mmol/h and increased to 12.6 mmol/h after eradication (P < 0.001), with no significant change in body atrophy or intestinal metaplasia.CONCLUSIONS: In some subjects, chronic H. pylori infection produces a body-predominant gastritis and profound suppression of gastric acid secretion that is partially reversible with eradication therapy.

AB - BACKGROUND & AIMS: We have identified a subgroup of Helicobacter pylori-infected subjects with low or absent gastric acid output. The aim of this study was to document the morphological and functional abnormalities in these subjects and to assess the effect of eradicating the infection.METHODS: The 16 hypochlorhydric subjects (6 men) had a mean age of 55 years (range, 36-79 years). They underwent a 14C-urea breath test, H. pylori serology, fasting gastrin, gastric autoantibodies, gastroscopy with antral and body biopsies, and measurement of peak acid output to pentagastrin (PAO(PG)). Their histology was compared with that of age- and sex-matched duodenal ulcer and nonulcer dyspepsia patients (16 each). H. pylori infection was eradicated in the hypochlorhydric subjects, and the investigations were repeated 6 months later.RESULTS: Compared with controls, the hypochlorhydric subjects had less dense H. pylori colonization, body-predominant colonization and gastritis, and increased prevalence of body atrophy and intestinal metaplasia. Median PAO(PG) before eradication in the hypochlorhydric subjects was 1.1 mmol/h and increased to 12.6 mmol/h after eradication (P < 0.001), with no significant change in body atrophy or intestinal metaplasia.CONCLUSIONS: In some subjects, chronic H. pylori infection produces a body-predominant gastritis and profound suppression of gastric acid secretion that is partially reversible with eradication therapy.

KW - Achlorhydria

KW - Biopsy

KW - Case-Control Studies

KW - Female

KW - Gastric Acid

KW - Gastric Mucosa

KW - Gastritis, Atrophic

KW - Helicobacter Infections

KW - Helicobacter pylori

KW - Humans

KW - Male

KW - Middle Aged

KW - Journal Article

KW - Research Support, Non-U.S. Gov't

M3 - Article

VL - 113

SP - 15

EP - 24

JO - Gastroenterology

JF - Gastroenterology

SN - 0016-5085

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ER -

El-Omar EM, Oien K, El-Nujumi A, Gillen D, Wirz A, Dahill S et al. Helicobacter pylori infection and chronic gastric acid hyposecretion. Gastroenterology. 1997 Jul;113(1):15-24.