Associations among Gastric Juice pH, Atrophic Gastritis, Intestinal Metaplasia and<i>Helicobacter pylori</i>Infection

Sung, Ji‐Hee; Kim, Nayoung; Lee, Jong-Chan; Hwang, Young Jin; Kim, Hyung Woo; Chung, Jung Wha; Kim, Jin Wook; Lee, Dong Hoon

doi:10.5009/gnl17063

Cited by 28 publications

(23 citation statements)

References 26 publications

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“…H. pylori infection can lead to antrum-predominant gastritis, in which the oxyntic mucosa is not inflamed but a gastrin-driven increase in acid output occurs, along with the possible development of duodenal ulcer[67,68]. In addition, when the infection does spread to the oxyntic mucosa, it causes pangastritis, which is associated with hypochloridria, and is responsible for the development of chronic atrophic gastritis, intestinal metaplasia and, finally, dysplasia and GC[69,70]. Several studies have shown that the bacterial migration from the antrum to gastric body and fundus occurs more frequently during long-term PPIs use[71].…”

Section: Stomachmentioning

confidence: 99%

Proton pump inhibitors and dysbiosis: Current knowledge and aspects to be clarified

Bruno¹,

Zaccari²,

Rocco³

et al. 2019

WJG

164

152

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Proton pump inhibitors (PPIs) are common medications within the practice of gastroenterology. These drugs, which act through the irreversible inhibition of the hydrogen/potassium pump (H+/K+-ATPase pump) in the gastric parietal cells, are used in the treatment of several acid-related disorders. PPIs are generally well tolerated but, through the long-term reduction of gastric acid secretion, can increase the risk of an imbalance in gut microbiota composition ( i.e ., dysbiosis). The gut microbiota is a complex ecosystem in which microbes coexist and interact with the human host. Indeed, the resident gut bacteria are needed for multiple vital functions, such as nutrient and drug metabolism, the production of energy, defense against pathogens, the modulation of the immune system and support of the integrity of the gut mucosal barrier. The bacteria are collected in communities that vary in density and composition within each segment of the gastrointestinal (GI) tract. Therefore, every change in the gut ecosystem has been connected to an increased susceptibility or exacerbation of various GI disorders. The aim of this review is to summarize the recently available data on PPI-related microbiota alterations in each segment of the GI tract and to analyze the possible involvement of PPIs in the pathogenesis of several specific GI diseases.

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Section: Stomachmentioning

confidence: 99%

Proton pump inhibitors and dysbiosis: Current knowledge and aspects to be clarified

Bruno¹,

Zaccari²,

Rocco³

et al. 2019

WJG

164

152

View full text Add to dashboard Cite

show abstract

“…Sung et al . [ 67 ] reported that the mean pH of gastric juice was higher in the H. pylori -positive group ( n = 17) than that in the H. pylori -negative group ( n = 29) (4.54 vs. 2.46, P = 0.002). Similarly, the amount of H. pylori was lower in the group at pH <3 (21.4%) than that in the group pH ≥3 (61.1%) ( P = 0.007).…”

Section: G Roup C: [H P (+)Pg(+mentioning

confidence: 99%

Gastric Cancer Screening by Combined Determination of Serum Helicobacter pylori Antibody and Pepsinogen Concentrations

Chen

Huang

et al. 2018

Chinese Medical Journal

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Objective:Gastroscopy combined with gastric mucosa biopsies is currently regarded as a gold standard for diagnosis of gastric cancer. However, its application is restricted in clinical practice due to its invasive property. A new noninvasive population screening process combining the assay of anti-Helicobacter pylori antibody and serum pepsinogen (PG) (ABC method) is adopted to recognize the high-risk patients for further endoscopy examination, avoiding the unnecessary gastroscopy for most population and saving the cost consumption for mass screening annually. Nevertheless, controversies exist for the grouping of ABC method and the intervals of gastroscopy surveillance for each group. In this review, we summarized these popular concerned topics for providing useful references to the healthcare practitioner in clinical practice.Data Sources:The PubMed databases were systematically searched from the inception dates to November 22, 2017, using the keywords “Helicobacter pylori,” “Pepsinogens,” and “Stomach Neoplasms.”Study Selection:Original articles and reviews on the topics were selected.Results:Anti-H. pylori antibody and serum PG concentration showed significant changes under the different status of H. pylori infection and the progression of atrophic gastritis, which can be used for risk stratification of gastric cancer in clinic. In addition, anti-H. pylori antibody titer can be used for further risk stratification of gastric cancer contributing to determine better endoscopy surveillance interval.Conclusions:The early detection and diagnosis of gastric cancer benefit from the risk stratification, but the cutoff values for H. pylori antibody and serum PG concentration require further modification.

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“…To prevent mucosal injury from acid and pepsin during the window between the irrigation of the mucosal surface and the renewal of the mucus layer, and to increase the eradication rate, we tried to control the intragastric pH to a level above 4 on the day of the ILTHPI through the administration of high-dose lansoprazole [ 29 ] (by orally disintegrating lansoprazole 60 mg immediately before ILTHPI and another 60 mg 8 to 10 h after). Although chronic H. pylori infection could result in the reduction of acid secretion to a level of hypoacidity from atrophy of the oxyntic mucosa [ 30 ], about 46% (46/100) in Group A and 46.6% (55/118) in Group B H. pylori -infected patients hadlevels of gastric juice pH that were still less than 4. A more effective strategy for rapid control of intragastric pH prior to ILTHPI is of paramount importance when it comes to improving the eradication rate of H. pylori for medicaments containing amoxicillin and clarithromycin.…”

Section: Discussionmentioning

confidence: 99%

The Impact of Gastric Juice pH on the Intraluminal Therapy for Helicobacter pylori Infection

Wang

Chen

et al. 2020

JCM

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Background: Helicobacter pylori (H. pylori) can be topically eradicated in stomach lumen on endoscopic examination. The procedures of intraluminal therapy for H. pylori infection (ILTHPI) include the control of intragastric pH, mucolytic irrigation of the gastric mucosal surface, and a single-dose medicament containing antimicrobial agents. Aims: To detect gastric juice pH and evaluate its impact on the success rate of ILTHPI. Methods: We enrolled 324 patients with upper abdominal discomfort for endoscopic examinations. Among them, 13C-urea breath test was positive in 218 patients, where 100 underwent ILTHPI, and negative in 106. All patients had their gastric juice pH detected and set into three ranges, including normal acidity (pH < 4.0), low-level hypoacidity (pH 4.0–5.5), and high-level hypoacidity (pH ≥ 6.0). The impact of gastric juice pH on the success rate of ILTHPI was evaluated. Results: Distribution of pH level showed no significant difference between two groups of H. pylori-infected patients (p = 0.942). The eradication rate of ILTHPI is significantly lower in patients with gastric juice pH below 4 (p < 0.001). Conclusions: Detection of gastric juice pH in ILTHPI is extremely important. Rapid control of stomach pH at or above 4 for patients prior to ILTHPI is strongly recommended. (NCT03124420).

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Associations among Gastric Juice pH, Atrophic Gastritis, Intestinal Metaplasia andHelicobacter pyloriInfection

Cited by 28 publications

References 26 publications

Proton pump inhibitors and dysbiosis: Current knowledge and aspects to be clarified

Proton pump inhibitors and dysbiosis: Current knowledge and aspects to be clarified

Gastric Cancer Screening by Combined Determination of Serum Helicobacter pylori Antibody and Pepsinogen Concentrations

The Impact of Gastric Juice pH on the Intraluminal Therapy for Helicobacter pylori Infection

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