Do antisecretory agents modify Helicobacter pylori gastritis?

In patients wit Helicobacter pylori (Hp) gastritis long-term treatment wit omeprazole leads to a worsening of the corpus gastritis. In the present ove rview we have analyzed the literature and our own studies to determine whet her this also applies to other proton pump inhibitors (PPI), H-2-receptor a ntagonists (H2-RA) and antacids. Results: Every antisecretory therapy - vagotomy, antacids, H2-RA and PPI - in patients with Hp gastritis leads to a worsening of the following paramet ers: Grade of gastritis, activity of gastritis, grade of replacement of fov eolar epithelium by regenerative epithelium and grade of mucus depletion. T he incidence of intestinal metaplasia does not increase. Atrophic gastritis has not been observed after one year of treatment; after five years of tre atment with PPI, development of atrophy is uncertain. In the antrum treatme nt wit PPI, but not wit antacids or H2-RA, leads to an improvement in the g astritis parameters. The question whether the aggravation of corpus gastrit is under antisecretory treatment might be detrimental over the long-term, w hether, for example, the more pronounced gastritis might increase the risk of a subsequent carcinoma, remains to be clarified by long-term studies.