Bile acid reflux and possible inhibition of Helicobacter pylori infection in subjects without gastric surgery

Bile acids are generally known to inhibit growth of Helicobacter pylori in vitro, but whether they do so in humans with no gastric surgery has been un certain. The present study addresses this issue. Among healthy control subj ects with preserved acid secretion, H. pylori-positive subjects were older and had lower gastric bile acid concentrations than H. pylori-negative subj ects (P < 0.05). Among gastric ulcer patients with preserved acid secretion , H. pylori-positive patients had a higher basal acid output than H. pylori -negative patients (P < 0.05). Among H. pylori-positive subjects with prese rved acid secretion, duodenal ulcer patients had a higher basal and maximum acid output than healthy control subjects (P < 0.01). In conclusion, gastr ic bile acids may suppress initial stages of H. pylori infection in subject s without gastric surgery. However gastric bile acids may have little effec t on peptic ulcer disease, once H. pylori infection is established.