Omeprazole and Helicobacter Pylori: temporary suppression rather than true eradication

Abstract

SUMMARY Twenty‐four Helicobacter pylori (H. pylori)‐positive patients were treated for 28 days with either 20 mg omeprazole o.m. (n= 12) or 40 mg omeprazole o.m. (n= 12). Clearance (absence of H. pylori at the end of or shortly after treatment) and eradication (absence of H. pylori 1 month after cessation of treatment) were assessed using the 14C‐urea breath test. Observed clearance and eradication were: 20 mg omeprazole 3/12 and 0/12; 40 mg omeprazole 6/12 and 1/12 respectively. The effect on H. pylori is probably due to the change in gastric pH from acid to neutral, however it is insufficient to recommend the inclusion of omeprazole in regimens aimed at eradicating H. pylori.

Negative Effect of Proton‐pump Inhibitors (PPIs) on Helicobacter pylori Growth, Morphology, and Urease Test and Recovery after PPI Removal – An In vitro Study

“…This could be due to the shift of bacterial distribution from the antrum to the body . False‐negative results of UBT have also been observed in up to 40% of patients with OMP consumption , while PAN consumption did not inhibit H. pylori urease activity with no negative effect on UBT . Helicobacter pylori was not observed in a considerable number of smears (44.7%) after maximum 60‐minutes microscopic searching.…”

Applicability of a short/rapid 13C-urea breath test for Helicobacter pylori: retrospective multicenter chart review study

“…Acidic gastric juices may also neutralize the ammonia, which may cause bacterial damage by itself and reduce urease activity [13]. …”

The Role of Helicobacter pylori in Peptic Ulcer Disease

“…At this neutral pH, the ammonia produced by H. pylori is no longer neutralized by hydrogen ions and therefore may cause direct bacterial damage. 54 In addition, omeprazole-induced achlorhydria may suppress H. pylori urease secretion, resulting in a biologically inactive bacteria. In its inactive state, it is postulated that the organism does not secrete phospholipases responsible for its path~genicity.~~ Because temporary suppression has been observed with omeprazole, its inclusion in regimens aimed at eradicating H. pylori is currently being evaluated.…”