Effects of high dose vitamin C treatment on Helicobacter pylori infection and total vitamin C concentration in gastric juice

Low gastric juice total vitamin C concentration in the presence of Helicoba cter pylori (H. pylori) infection probably plays a role in gastric carcinog enesis. In vitro vitamin C has been shown to inhibit the growth of H. pylor i. The aims of this study were to determine the effect of high dose vitamin C administration on H. pylori infection and on gastric juice total vitamin C concentration in patients with H. pylori related chronic gastritis. Sixt y patients with dyspeptic symptoms and proven chronic gastritis and H. pylo ri infection, who were undergoing routine endoscopy, entered the study afte r giving informed consent. They were randomly coded into two treatment grou ps. Group 1 (controls, n = 28) were treated with antacids for 4 weeks and G roup 2 (n = 32) received vitamin C 5g daily also for 4 weeks. Nine patients did not complete the study and were excluded. Plasma and gastric juice tot al vitamin C levels were measured at baseline, at the end of 4 weeks treatm ent and again 4 weeks after treatment cessation. In the control group H. py lori infection remained unchanged in all 24 patients throughout as did the mean gastric juice total vitamin C concentration. However, in the vitamin C treated group eight of 27 patients (30%) who completed the treatment cours e the H. pylori infection was eradicated (P = 0.01). In these patients the mean gastric juice total vitamin C concentration rose significantly from 7. 2 +/- 1.6 mu g/ml after 4 weeks treatment (P < 0.001) and 19.8 mu g/ml 4 we eks after treatment was discontinued (P < 0.001). In the remaining 19 patie nts with persistent H. pylori infection, the mean gastric juice total vitam in C concentration rose less than in those,vith successful H. pylori eradic ation; 6.3 +/- 1.7 mu g/ml before treatment, 10.8 +/- 1.5 mu g/ml after 4 w eeks treatment (P < 0.05) and a return to pre-treatment levels (7.1 +/- 2.7 mu g/ml) 4 weeks after vitamin C intake stopped. There were no side effect s of vitamin C treatment. This study has shown that 4 weeks daily high dose vitamin C treatment in H. pylori infected patients,vith chronic gastritis resulted in apparent H. pylori eradication in 30% of those treated. In thos e patients there was also a highly significant rise in gastric juice total vitamin C concentration which persisted for at least 4 weeks after the trea tment ceased. A significant, though less marked, gastric juice total vitami n C concentration increase was observed during vitamin C treatment even in subjects,vith persistent H. pylori infection, though this was not maintaine d after treatment ended. The mechanism whereby vitamin C treatment appeared to result in H. pylori eradication is unclear. Further confirmatory studie s are indicated. (C) Lippincott Williams & Wilkins.