CHANGES IN HELICOBACTER PYLORI-INDUCED GASTRITIS IN THE ANTRUM AND CORPUS DURING 12 MONTHS OF TREATMENT WITH OMEPRAZOLE AND LANSOPRAZOLE INPATIENTS WITH GASTROESOPHAGEAL REFLUX DISEASE

Background: Several studies have shown that treatment with omeprazole leads to aggravation of Helicobacter pylori gastritis in the corpus. W hether this also applies to lansoprazole, and whether, in comparison w ith omeprazole, there are differences in therapy-induced gastritis par ameter changes remains unclear. Methods: In 111 patients infected with H. pylori and with gastro-oesophageal reflux disease we investigated the gastritis parameters in antral and corpus mucosa before and after 2, 6 and 12 months of treatment with 15 or 30 mg lansoprazole or 20 mg omeprazole/day. Results: In all groups the different treatments had a similar effect: in both regions of the stomach, suppression or partia l elimination of H. pylori was seen. However, improvement in the infla mmation was observed only in the antrum, while in the corpus most gast ritis parameters worsened significantly. There was no increase in inte stinal metaplasia or atrophy. Conclusion: In common with omeprazole, l ansoprazole aggravates the gastritis parameters in the corpus but impr oves them in the antrum. Treatment with proton pump inhibitors does no t result in any increase in the incidence of atrophy/intestinal metapl asia, However, as gastritis predominating in the corpus seems to be as sociated with an elevated carcinogenic risk, consideration should be g iven to prophylactic H. pylori eradication therapy before initiating p roton pump inhibitor treatment.