The gastric acid pocket is attenuated in H. pylori infected subjects

Mitchell, D. R., Derakhshan, M. H., Wirz, A. A., Orange, C., Ballantyne, S. A., Going, J. J. and McColl, K. E.L. (2017) The gastric acid pocket is attenuated in H. pylori infected subjects. Gut, 66(9), pp. 1555-1562. (doi: 10.1136/gutjnl-2016-312638) (PMID:27663505)

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Abstract

Objective Gastric acid secretory capacity in different anatomical regions, including the postprandial acid pocket, was assessed in Helicobacter pylori positive and negative volunteers in a Western population. Design We studied 31 H. pylori positive and 28 H. pylori negative volunteers, matched for age, gender and body mass index. Jumbo biopsies were taken at 11 predetermined locations from the gastro-oesophageal junction and stomach. Combined high-resolution pH metry (12 sensors) and manometry (36 sensors) was performed for 20 min fasted and 90 min postprandially. The squamocolumnar junction was marked with radio-opaque clips and visualised radiologically. Biopsies were scored for inflammation and density of parietal, chief and G cells immunohistochemically. Results Under fasting conditions, the H. pylori positives had less intragastric acidity compared with negatives at all sensors >1.1 cm distal to the peak lower oesophageal sphincter (LES) pressure (p<0.01). Postprandially, intragastric acidity was less in H. pylori positives at sensors 2.2, 3.3 and 4.4 cm distal to the peak LES pressure (p<0.05), but there were no significant differences in more distal sensors. The postprandial acid pocket was thus attenuated in H. pylori positives. The H. pylori positives had a lower density of parietal and chief cells compared with H. pylori negatives in 10 of the 11 gastric locations (p<0.05). 17/31 of the H. pylori positives were CagA-seropositive and showed a more marked reduction in intragastric acidity and increased mucosal inflammation. Conclusions In population volunteers, H. pylori positives have reduced intragastric acidity which most markedly affects the postprandial acid pocket.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Wirz, Sister Angela and Derakhshan, Dr Mohammad and Orange, Miss Clare and Ballantyne, Dr Stuart and McColl, Professor Kenneth and Mitchell, David and Going, Dr James
Authors: Mitchell, D. R., Derakhshan, M. H., Wirz, A. A., Orange, C., Ballantyne, S. A., Going, J. J., and McColl, K. E.L.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cancer Sciences
College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
College of Medical Veterinary and Life Sciences > Institute of Infection Immunity and Inflammation
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Journal Name:Gut
Publisher:BMJ Publishing Group
ISSN:0017-5749
ISSN (Online):1468-3288
Published Online:23 September 2016
Copyright Holders:Copyright © 2016 BMJ Publishing Group
First Published:First published in Gut 66(9):1555-1562
Publisher Policy:Reproduced in accordance with the copyright policy of the publisher

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