INTERACTIONS BETWEEN HELICOBACTER-PYLORI INFECTION, GASTRIC-ACID SECRETION AND ANTI-SECRETORY THERAPY

There is evidence of a two-way interaction between gastric acid secret ion and H. pylori-associated gastritis. Gastric acid secretion influen ces the density of H. pylori colonisation, its distribution within the stomach and the severity of the mucosal inflammatory response to the infection. In addition, H. pylori gastritis alters gastric acid secret ion. In subjects with a predominant antral gastritis, it increases aci d secretion predisposing to duodenal ulcer, whereas in others with pre dominant body gastritis, acid secretion is impaired and the subjects h ave an increased risk of gastric cancer. The two-way interaction betwe en acid secretion and H. pylori gastritis is observed when H. pylori-p ositive subjects are treated with proton pump inhibitor agents. The in hibition of acid secretion induces a body gastritis and this inflammat ion of the body mucosa inhibits acid secretion thus augmenting the ant i-secretory effect of the drug. In this article, we discuss the intera ction between gastric acid secretion and H. pylori gastritis and its i mportance in determining disease outcome.