| [ Summary ] |
Several studies in western countries have indicated the possibility that chronic use of proton pump inhibitor (PPI) in H.pylori-positive patients may intensify body gastritis and even promote progression of atrophic gastritis. This review was discussed to determine the effects of antisecretory agents on gastritis of the corpus, in Japan. In our study, those with slight infiltrations of neutrophils prior to treatment initiation, body gastritis was intensified by initial PPI therapy, and gradually improved through subsequent maintenance therapy with H2-blockers. On the other hand, for those with moderate or severe infiltration of neutrophils into the gastric body, the occurance of gastritis was improved by initial PPI therapy and further decreased through subsequent therapy with H2-blockers. In 5 patients who received only PPI for at least 3 years, although gastritis was transiently intensified in the body, reduction in both H.pylori density and infiltration of inflammatory cells was noted one year after PPI therapy initiation. Our study results suggest that in Japanese subjects whose gastric acid secreting capacity is as high as that noted in Caucasians, acid-suppressive therapy with PPI and H2-blockers will intensify body gastritis, whereas in many Japanese cases, such antisecretory therapy may lead to a reduction in H.pylori density, resulting in improvement of body gastritis. It was concluded that we need precise examination regarding the effects of acid inhibitory agents on body gastritis in certain individuals. |