| Theme | PPI Therapy | |
|---|---|---|
| Title | Effect of Proton Pump Inhibitors on Helicobacter pylori Related Gastritis | |
| Publish Date | 2002/02 | |
| Author | Naomi Uemura | Department of Gastroenterology, Kure Kyosai Hospital |
| [ Summary ] | Several studies in western countries have shown that long-term use of proton pump inhibitors (PPI) aggravates corpus gastritis in patients with Helicobacter pylori infection, promoting the development of atrophic gastritis. We studied the effects of long-term use of antisecretory agents on the H. pylori-positive gastric mucosa in Japan. The long-term use of famotidine, after 8 weeks of treatment with PPIs, distinctly decreased H. pylori density and neutrophil infiltration in the antrum, but did not change H. pylori density in the corpus. The gastritis score increased in patients who had no, or mild, corpus gastritis before treatment and significantly decreased, in those who had moderate or severe gastritis before treatment. In 11 patients who received long-term treatment with PPIs alone, neutrophil infiltration and H. pylori density decreased, not only in the antrum but, also in the corpus. There was no increase in intestinal metaplasia or mucosal atrophy as assessed endoscopically during follow-ups. Changes in corpus gastritis, in response to acid-suppressive therapy, may depend on the severity of gastritis before treatment. Long-term use of PPIs apparently does not accelerate the development of atrophy or intestinal metaplasia in Japanese patients. We must examine the relationship between long-termuse of PPIs and changes in histologic gastritis patterns in the future. |
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