Increasing gastric juice pH level prior to anti-Helicobacter pylori therapy may be beneficial to the healing of duodenal ulcers

The aim of this study was to observe the efficacy of clarithromycin-based triple therapy for Helicobacter pylori (Hp)-infected duodenal ulcer when combined with different pH levels of gastric juices. A total of 160 patients with Hp-infected duodenal ulcers were randomly allocated into two groups. Patients in the treatment group (n=80) were administered a 20-mg dose of omeprazole twice daily for 1 week and then the treatment and control groups (n=80) received therapy for Hp infection and duodenal ulcers. We observed the ulcer healing stage, the content of anti-Hp IgA in gastric juice and the Hp eradication rate before and after proton pump inhibitor therapy in the two groups. Results revealed that the Hp eradication rate in the treatment group was 93% compared with 81% in the control group, and the difference was statistically significant (P<0.05). The ulcer healing rate in the treatment group was 93%, compared with 70% in the control group (P<0.05). A positive linear correlation was observed between gastric pH and the content of anti-Hp IgA in gastric juice (P<0.05). Increasing gastric pH prior to anti-Hp therapy may be beneficial to the eradication of Hp and for promoting the healing of duodenal ulcers.

[1]  G. Guariso,et al.  Helicobacter pylori Eradication Therapy: Current Availabilities , 2012, ISRN gastroenterology.

[2]  S. Itai,et al.  Stabilization mechanism of clarithromycin tablets under gastric pH conditions. , 2011, Chemical & pharmaceutical bulletin.

[3]  P. Malfertheiner,et al.  Helicobacter pylori eradication with a capsule containing bismuth subcitrate potassium, metronidazole, and tetracycline given with omeprazole versus clarithromycin-based triple therapy: a randomised, open-label, non-inferiority, phase 3 trial , 2011, The Lancet.

[4]  B. Corthésy Role of secretory immunoglobulin A and secretory component in the protection of mucosal surfaces. , 2010, Future microbiology.

[5]  M. Tomić,et al.  Antimicrobial resistance of H. pylori to the outcome of 10-days vs. 7-days Moxifloxacin based therapy for the eradication: a randomized controlled trial , 2010, Annals of Clinical Microbiology and Antimicrobials.

[6]  N. Manojlovic,et al.  Anti Helicobacter pylori IgG and IgA response in patients with gastric cancer and chronic gastritis. , 2008, Hepato-gastroenterology.

[7]  T Rokkas,et al.  Current concepts in the management of Helicobacter pylori infection: the Maastricht III Consensus Report , 2006, Gut.

[8]  G. Watkinson,et al.  Peptic ulcer disease , 1985, Digestive Diseases and Sciences.

[9]  P. Malfertheiner,et al.  Current concepts in the management of Helicobacter pylori infection—The Maastricht 2‐2000 Consensus Report , 2002, Alimentary pharmacology & therapeutics.

[10]  C. O'Morain,et al.  Helicobacter pylori Infection , 1994 .

[11]  C. Soussy,et al.  Effect of pH on the susceptibility of Helicobacter pylori to the ketolide telithromycin (HMR 3647) and clarithromycin. , 2001, The Journal of antimicrobial chemotherapy.

[12]  M. Asaka,et al.  Peptic ulcer recurrence during maintenance therapy with H2-receptor antagonist following first-line therapy with proton pump inhibitor , 2000, Journal of Gastroenterology.

[13]  N. Lehn,et al.  Secondary Resistance Among 554 Isolates of Helicobacter pylori After Failure of Therapy , 2000, European Journal of Clinical Microbiology and Infectious Diseases.

[14]  Mukhopadhyay,et al.  High prevalence of Helicobacter pylori infection with dual resistance to metronidazole and clarithromycin in Hong Kong , 2000, Alimentary pharmacology & therapeutics.

[15]  L. Fändriks,et al.  Conceivable mechanisms by which Helicobacter pylori provokes duodenal ulcer disease. , 2000, Bailliere's best practice & research. Clinical gastroenterology.

[16]  G. Gościniak IgG and IgA antibodies in Helicobacter pylori infections. , 1997, Zentralblatt fur Bakteriologie : international journal of medical microbiology.

[17]  G. Gościniak,et al.  Helicobacter pylori antibodies in sera of children suffering from chronic abdominal pain. , 1993, Zentralblatt fur Bakteriologie : international journal of medical microbiology.

[18]  A. Hirschl,et al.  Comparison of ELISA antigen preparations alone or in combination for serodiagnosing Helicobacter pylori infections. , 1990, Journal of clinical pathology.

[19]  M. Losowsky,et al.  Systemic and local antibody responses to gastric Campylobacter pyloridis in non-ulcer dyspepsia. , 1986, Gut.