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Open AccessArticle

The Reduction in Gastric Atrophy after Helicobacter pylori Eradication Is Reduced by Treatment with Inhibitors of Gastric Acid Secretion

1
Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
2
Department of Gastroenterology, Tokyo Metropolitan Police Hospital, Tokyo 164-8541, Japan
3
Department of Gastroenterology & Hepatology, Nagoya University Graduate School of Medicine, Nagoya 466-8560, Japan
4
Department of Pathology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan
*
Authors to whom correspondence should be addressed.
Int. J. Mol. Sci. 2019, 20(8), 1913; https://doi.org/10.3390/ijms20081913
Received: 5 March 2019 / Revised: 15 April 2019 / Accepted: 16 April 2019 / Published: 18 April 2019
(This article belongs to the Special Issue Proton-Pump Inhibitors (PPIs))
Background: Helicobacter pylori (H. pylori) eradication therapy may improve gastric atrophy and intestinal metaplasia, but the results of previous studies have not always been consistent. The aim of this study was to compare the histological changes of intestinal metaplasia and gastric atrophy among the use of acid-suppressing drugs after H. pylori eradication. Methods: A cohort of 242 patients who underwent successful eradication therapy for H. pylori gastritis and surveillance endoscopy examination from 1996 to 2015 was analyzed. Changes in the histological scores of intestinal metaplasia and atrophy according to drug use (proton-pump inhibitors (PPIs), H2 receptor antagonists (H2RAs), and non-acid suppressant use) were evaluated in biopsies of the antrum and corpus using a generalized linear mixed model in all patients. Results: The mean follow-up period and number of biopsies were 5.48 ± 4.69 years and 2.62 ± 1.67 times, respectively. Improvement in the atrophy scores of both the antrum (p = 0.042) and corpus (p = 0.020) were significantly superior in patients with non-acid suppressant drug use compared with those of PPI and H2RA use. Metaplasia scores in both the antrum and corpus did not improve in all groups, and no significant differences were observed among groups in the antrum (p = 0.271) and corpus (p = 0.077). Conclusions: Prolonged acid suppression by PPIs or H2RAs may limit the recovery of gastric atrophy following H. pylori eradication. View Full-Text
Keywords: H. pylori eradication; atrophy; proton pump inhibitors (PPIs) H. pylori eradication; atrophy; proton pump inhibitors (PPIs)
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Niikura, R.; Hayakawa, Y.; Hirata, Y.; Ogura, K.; Fujishiro, M.; Yamada, A.; Ushiku, T.; Konishi, M.; Fukayama, M.; Koike, K. The Reduction in Gastric Atrophy after Helicobacter pylori Eradication Is Reduced by Treatment with Inhibitors of Gastric Acid Secretion. Int. J. Mol. Sci. 2019, 20, 1913.

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