Vitamin C, Gastritis, and Gastric Disease: A Historical Review and Update

Abstract

The discovery of Helicobacter pylori as the cause of gastritis and peptic ulcers ushered in the modern era of research into gastritis and into acid-peptic diseases and rekindled interest in the role of ascorbic acid in the pathophysiology and treatment of gastritis and peptic ulcer disease. Here, we review historic and modern studies on ascorbic acid and gastric diseases with an emphasis on H. pylori gastritis and its sequelae. The relationship of ascorbic acid and gastritis and peptic ulcer and its complications was extensively studied during the 1930’s through the 1950’s. Much of this extensive literature has been effectively “lost”. Ascorbic acid deficiency was associated with all forms of gastritis (e.g., autoimmune, chemical, and infectious) due in varying degrees to insufficient intake, increased metabolic requirements, and destruction within the GI tract. Importantly, gastritis-associated abnormalities in gastric ascorbic acid metabolism are reversed by H. pylori eradication and potentially worsened by proton pump inhibitor (PPI) therapy. Diets rich in naturally occuring ascorbic acid are associated with protection of the gastric corpus from atrophy and a reduction in the incidence of gastric cancer possibly through the ability of ascorbic acid to reduce oxidative damage to the gastric mucosa by scavenging carcinogenic N-nitroso compounds and free radicals and attenuating the H. pylori-induced inflammatory cascade. Ascorbic acid supplementation was possibly associated with a decreased incidence of bleeding from peptic ulcer disease. Pharmacologic doses of ascorbic acid also may improve the effectiveness of H. pylori eradication therapy. Occasionally, looking back can help plot the way forward.

Water-Soluble Vitamin Deficiencies in Complicated Peptic Ulcer Patients Soon after Ulcer Onset in Japan

“…Discontinuation of prophylactic long-term PPI treatment may easily lead to peptic ulcer recurrence through the malabsorption of watersoluble vitamins. Therefore, supplementation of watersoluble vitamins seems to be of particular importance in high-risk patients with complicated peptic ulcers that require prophylactic long-term PPI treatment (37).…”

Ascorbic acid in the prevention and treatment of cancer

“…It is acquired through the ingestion of various plants, especially citrus fruits such as lemon and orange, and vegetables including tomatoes and broccoli, with recommended daily doses of 90 mg for men and 75 mg for women. 13 Table 1 shows the clinical and non-clinical studies on the use of ascorbic acid as an antioxidant in the treatment and/or prevention of cancer, describing its use in several types of cancer or cell lines at different doses/concentrations and their mechanisms of action. The clinical studies (2) involved different types of cancer (pancreas, breast, kidney, lung, liver, bladder, lymphoma, prostate, colon, brain, leukemia, stomach, ovary, skin, and uterus) and doses of ascorbic acid (0.04-0.28 mM; 1-10 mM); the non--clinical studies (10) used different tumor cell lineages (MCF-7 cells in breast cancer; renal carcinoma; B16FO Plants and most animals synthesize ascorbic acid using glucose.…”

Gastritis and Peptic Ulcer Diseases in Dogs: A Review

“…Vitamin -C is necessarily required for absorption of antioxidants like N-acetylcysteine, and alphatocopherol in young dogs while in geriatric patient, the oral dosage of Vitamine C gives minor antioxidant and immunological effects (Hall et al, 2006;Ogawa et al, 2008;Hesta et al, 2009). Ascorbic acid reduces oxidative damage to the gastric mucosal layer by scavenging ROS and attenuating the H. pylori-induced inflammatory cascade leads to decreased incidence of gastric carcinoma and bleeding from peptic ulcer disease (Aditi et al, 2012). During scavenging of free oxygen radicals by ascorbic acid produces 2-fold greater amount of ascorbyl radicals in the H. pylori-infected gastric mucosa (Drake et al, 1998).…”