Acid suppression and the gastric flora

Heatley, R. V.; Sobala, G. M.

doi:10.1016/0950-3528(93)90036-r

Cited by 5 publications

(3 citation statements)

References 76 publications

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“…Increased death from gastric cancer after a lag phase of 20 years had been found by most authors, but not of cancers at other sites (except cancers related to tobacco smoking) [Moller & Toftgaard 1991;Tersmette et al 1991]. The clinical significance of acid suppression and changes in gastric flora, particularly in relation to gastric cancer, has been extensively investigated and debated and yet remains highly controversial (Heatley & Sobala 1993).…”

Section: Gastric Bacterial Overgrowthmentioning

confidence: 98%

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Risk-Benefit Assessment of Omeprazole in the Treatment of Gastrointestinal Disorders

Creutzfeldt

1994

Drug Safety

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For the treatment of duodenal and gastric ulcer and reflux oesophagitis, especially erosive oesophagitis, omeprazole has an advantage over histamine H2-receptor antagonists because it heals significantly more patients significantly faster. Adverse effects have been observed during short term treatment with the same frequency as during treatment with H2-antagonists. Also, maintenance treatment with omeprazole of reflux oesophagitis is significantly superior to H2-antagonist therapy. During long term treatment for up to 8 years no further drug-related adverse effects have been observed. Moderate hypergastrinaemia occurs in some patients, especially if an omeprazole dosage of 40 mg/day is needed. A slight increase of the agyrophil (endocrine) cell volume density and an extension of micronodular hyperplasia in the oxyntic mucosa after several years of omeprazole treatment seem to be related to the severity of the corpus gastritis and not to drug-induced hypergastrinaemia, because similar changes have been observed in equal frequency in patients not receiving anti-secretory drugs. Theoretical arguments against long term treatment with potent acid-suppressing drugs, such as the possible consequences of gastric bacterial overgrowth or hypergastrinaemia, are not supported by clinical observations and epidemiological data and are, therefore, speculative.

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Section: Gastric Bacterial Overgrowthmentioning

confidence: 98%

“…According to the so-called nitrosamine or Correahypothesis of carcinogenesis, hypochlorhydria leads to bacterial overgrowth and the formation of potentially noxious N-nitrosocompounds in the stomach. However, the chemical fmdings are controversial (Hall et al 1986Heatley & Sobala 1993;Houghton et al 1989).…”

Section: Gastric Bacterial Overgrowthmentioning

confidence: 99%

Risk-Benefit Assessment of Omeprazole in the Treatment of Gastrointestinal Disorders

Creutzfeldt

1994

Drug Safety

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“…During passage through the stomach, the viability of probiotic bacteria incorporated in a food matrix is influenced by stress factors like acid, enzymes and mechanical shear due to strong peristaltic contractions (Heatley and Sobala, 1993;Simon and Gorbach, 1987). Many probiotic bacteria are known to be acid sensitive (Shah and Jelen 1990;Berrada et al, 1991;Mituoka 1992;Shah and Lankaputhra 1997;Gardiner et al, 2000).…”

Section: Gastric Secretionmentioning

confidence: 99%

Evaluation of viability of Lactobacillus acidophilus La-5 during simulated digestion process using a dynamic in vitro model

Tharani¹

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In recent years, there has been an upsurge in medical research assessing the therapeutic benefits of probiotic bacteria and growing commercial interest in food fortification with these bacteria. Probiotic bacteria such as L. acidophilus are known to be predominant Lactobacilli species in the intestinal tract of healthy humans and suggested to provide clinical health benefits such as enhancement of immunity against intestinal infections, prevention of diarrhea and hypercholesterolaemia and improvement in lactose utilization. Many studies have demonstrated the possibility of incorporating probiotic bacteria in an ice cream matrix and shown its viability can be maintained throughout the shelf life of the ice cream. However, there is limited information about the protective effect of ice cream on viability of incorporated probiotic bacteria during simulated gastric digestion using an in vitro dynamic model stomach. In phase one of this study, a preliminary study was conducted to determine the effect of air addition on the viability of L. acidophilus La-5. This was done by manufacturing low fat (4%) non-fermented ice cream mix supplemented with L. acidophilus La-5 to yield an initial population of 10 7 cfu/g. The mix was processed with 60% and 100% overrun (OR) and stored at-10ᵒC for 90 days. The effect of air addition at different levels was tested post freezing and every 30 days throughout its shelf life of 90 days. The results showed less than one log reduction in the viable counts of L. v acidophilus La-5 for both samples incorporated with 60% and 100% OR after freezing and the number of viable cells did not differ significantly (p>0.05) from day 1 to day 90. In phase two of this study, a 2 2 full factorial experimental design was used to evaluate whether the viscous nature of ice cream mix plays an important role in improving the survivability of L. acidophilus La-5 during simulated digestion against low pH and presence of mechanical shear and to determine whether initial inoculation level has any effect on the viability of L. acidophilus La-5 at the end of 2 hr simulated digestion. Non-fermented low fat (5%) ice cream mixes with high and low viscosity were produced by changing the amount of stabilizer/emulsifier blend and each of the two mixes were supplemented with two levels of L. acidophilus La-5 to obtain an initial population of 10 8 cfu/g and 10 6 cfu/g before freezing. These mixes were frozen with 60% overrun. The ice cream samples were digested for 2 hr in an in vitro model stomach called Human Gastric Simulator (HGS). This model included factors such as gastric secretions, mechanical shearing due to peristaltic contractions and temperature and pH control. No significant effect (p>0.05) of different levels of viscosity on the survivability of L. acidophilus La-5 was found during and at the end of 2 hr simulated in vitro digestion, irrespective of the difference in initial inoculation level. The initial supplementation level of L. acidophilus La-5 had a significant impact (p<0.05) on its survivability dur...

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Consequences of gastric acid inhibition in man

Creutzfeldt¹

1999

Proton Pump Inhibitors

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Acid suppression and the gastric flora

Cited by 5 publications

References 76 publications

Risk-Benefit Assessment of Omeprazole in the Treatment of Gastrointestinal Disorders

Risk-Benefit Assessment of Omeprazole in the Treatment of Gastrointestinal Disorders

Evaluation of viability of Lactobacillus acidophilus La-5 during simulated digestion process using a dynamic in vitro model

Consequences of gastric acid inhibition in man

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