A Chronological Increase in Gastric Acid Secretion from 1995 to 2014 in Young Japanese Healthy Volunteers under the Age of 40 Years Old

Abstract

Gastric acid secretion levels are an important determinant of the manifestation of acid-related upper GI diseases such as gastroesophageal reflux disease. We recently reported that gastric acid secretion levels did not change from the 1990s to 2010s in H. pylori-negative asymptomatic Japanese outpatients with a mean age of 63 years old. However, because young people have a quite different lifestyle, including dietary pattern, from elderly people in Japan, it is worth investigating any chronologic changes in gastric acid secretion in younger generations. The aim of this analysis is to investigate the potential changes in gastric acid secretion from 1995 to 2014 in young Japanese healthy volunteers. Eighty-eight young Japanese healthy volunteers under the age of 40 with a mean age of 26 were extracted from a database accumulated from 1995 to 2014 for the present analysis. Their gastrin-stimulated gastric acid level was determined with the endoscopic gastrin test. In 76 H. pylori-negative subjects, gastric acid secretion levels showed a significant positive correlation with the calendar year when the test was performed (r = 0.27, p < 0.01). A similar trend was observed in 12 H. pylori-positive subjects. A chronological 5-year time period showed a significant positive association with gastric acid secretion in univariate and multivariate analyses (p < 0.01 and p = 0.01, respectively). Gastric acid secretion levels have been increasing in young Japanese healthy volunteers during the last 20 years. We need to monitor future trends in the prevalence of acid-related diseases such as gastro-esophageal reflux disease in Japan.

Clinicopathological features of Siewert type II adenocarcinoma: comparison of gastric cardia adenocarcinoma and Barrett’s esophageal adenocarcinoma following endoscopic submucosal dissection

“…This may be because gastric acid secretion is increasing due to a decrease in H. pylori (HP) infection [28]. Furthermore, Iijima et al reported that gastric acid secretion in young people who are negative for HP infection is also increasing [29]. Schneider and Corley reported that the continuing decline in HP infection could lead to the disappearance of duodenal ulcers and distal gastric cancers and a marked increase in GERD, Barrett's esophagus, and BEA [30].…”

Trends in gastroesophageal reflux disease in Japanese children and adolescents

“…The increase in GERD identified in this study may reflect the increase in gastric acid secretion associated with the changes in diet and reduction of H. pylori in Japan. 10,12,20 An increase in gastric acid secretion could also be responsible for the proportion of GERD patients with endoscopic Barrett's esophagus significantly increasing between the two periods (i.e. 24/45 [53.3%] vs 8/31 [25.8%], P = 0.017) ( Table 2).…”

“…It has been reported that between 1995 and 2014 the level of gastric acid secretion increased in healthy young Japanese, 10 whereas over the last 40 years, the age‐specific severity of gastric atrophy and gastric mucosal intestinal metaplasia has declined remarkably 11 . This trend has been most marked in young adults (20–39 years).…”

“…6 Typical endoscopic findings for GERD include structural abnormalities such as hiatal hernia and mucosal findings such as erosions, stricture or Barrett's esophagus. [6][7][8][9] It has been reported that between 1995 and 2014 the level of gastric acid secretion increased in healthy young Japanese, 10 whereas over the last 40 years, the age-specific severity of gastric atrophy and gastric mucosal intestinal metaplasia has declined remarkably. 11 This trend has been most marked in young adults (20-39 years).…”

Factors associated with the presentation of erosive esophagitis symptoms in health checkup subjects: A prospective, multicenter cohort study

“…One possible reason for this change is an increase in gastric acid secretion in the Japanese population, irrespective of Helicobacter pylori infection [ 18 ]. Since dietary fat intake has been reported to stimulate gastric acid secretion in mice [ 19 ], the chronological increase in gastric acid secretion in Japanese people may be related to an increase in fat intake [ 20 ]. In addition, because H .…”