THE DEVELOPMENT OF ATROPHIC GASTRITIS - HELICOBACTER-PYLORI AND THE EFFECTS OF ACID SUPPRESSIVE THERAPY

Helicobacter pylori is uniquely adapted to survival in the strongly ac idic gastric lumen. In vitro, both acid and certain acid suppressors a ffect bacterial growth. In vivo, there is little evidence that acid su ppressors have any effect on bacterial survival. In contrast, decrease of acid secretion quickly leads to a spreading of the bacterial infec tion throughout the body and fundus of the stomach, which is accompani ed by an increase of the associated gastritis. Helicobacter pylori gas tritis may, in a substantial number of infected subjects, ultimately l ead to atrophy and intestinal metaplasia, conditions with an increased risk for gastric cancer. This review summarizes the data on the inter relation between Helicobacter pylori, gastric acid secretion and devel opment of atrophic gastritis.