Skip to main content
Gut logoLink to Gut
. 1995 Apr;36(4):534–538. doi: 10.1136/gut.36.4.534

A substantial proportion of non-ulcer dyspepsia patients have the same abnormality of acid secretion as duodenal ulcer patients.

E el-Omar 1, I Penman 1, J E Ardill 1, K E McColl 1
PMCID: PMC1382492  PMID: 7737559

Abstract

Acid secretion in response to gastrin releasing peptide (GRP) is increased six-fold in Helicobacter pylori positive duodenal ulcer (DU) patients and threefold in H pylori positive healthy volunteers, and this fully resolves after eradication of the infection. This study was undertaken to determine whether a proportion of H pylori positive patients with non-ulcer dyspepsia (NUD) have an acid secretion disturbance similar to DU patients. Basal and GRP stimulated gastrin concentrations and acid output were examined in 25 H pylori positive NUD patients and the results compared with those of 25 H pylori positive healthy volunteers, 25 H pylori negative healthy volunteers, and 25 H pylori positive DU patients. Compared with the H pylori negative healthy volunteers, GRP stimulated gastrin was increased approximately three fold in each of the three infected groups. GRP stimulated acid secretion (median, range) was higher in the H pylori positive NUD patients (29.6 mmol/h (5.2-46.5)) (p < 0.005) than in the H pylori positive healthy volunteers (19.0 (1.0-38.3)) (p < 0.001) or H pylori negative healthy volunteers (6.3 (2.8-20.9)) (p < 0.0001). The H pylori positive NUD patients, however, had lower acid output than the DU patients (39.1 (17.9-64)) (p < 0.005). These findings are consistent with approximately 50% of the NUD patients having a similar disturbance of GRP stimulated acid secretion to DU patients.

Full text

PDF
538

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Adami H. O., Agenäs I., Gustavsson S., Löf L., Nyberg A., Nyrén O., Tyllström J. The clinical diagnosis of 'gastritis'. Aspects of demographic epidemiology and health care consumption based on a nationwide sample survey. Scand J Gastroenterol. 1984 Mar;19(2):216–219. [PubMed] [Google Scholar]
  2. Beardshall K., Moss S., Gill J., Levi S., Ghosh P., Playford R. J., Calam J. Suppression of Helicobacter pylori reduces gastrin releasing peptide stimulated gastrin release in duodenal ulcer patients. Gut. 1992 May;33(5):601–603. doi: 10.1136/gut.33.5.601. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Burland W. L., Hawkins B. W., Beresford J. Cimetidine treatment for the prevention of recurrence of duodenal ulcer: an international collaborative study. Postgrad Med J. 1980 Mar;56(653):173–176. doi: 10.1136/pgmj.56.653.173. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Gilbert D. A., Silverstein F. E., Tedesco F. J., Buenger N. K., Persing J. The national ASGE survey on upper gastrointestinal bleeding. III. Endoscopy in upper gastrointestinal bleeding. Gastrointest Endosc. 1981 May;27(2):94–102. doi: 10.1016/s0016-5107(81)73157-2. [DOI] [PubMed] [Google Scholar]
  5. Graham D. Y., Opekun A., Lew G. M., Evans D. J., Jr, Klein P. D., Evans D. G. Ablation of exaggerated meal-stimulated gastrin release in duodenal ulcer patients after clearance of Helicobacter (Campylobacter) pylori infection. Am J Gastroenterol. 1990 Apr;85(4):394–398. [PubMed] [Google Scholar]
  6. Graham D. Y., Opekun A., Lew G. M., Klein P. D., Walsh J. H. Helicobacter pylori-associated exaggerated gastrin release in duodenal ulcer patients. The effect of bombesin infusion and urea ingestion. Gastroenterology. 1991 Jun;100(6):1571–1575. doi: 10.1016/0016-5085(91)90654-4. [DOI] [PubMed] [Google Scholar]
  7. Heatley R. V., Rathbone B. J. Dyspepsia: a dilemma for doctors? Lancet. 1987 Oct 3;2(8562):779–782. doi: 10.1016/s0140-6736(87)92509-8. [DOI] [PubMed] [Google Scholar]
  8. Johnsen R., Bernersen B., Straume B., Førde O. H., Bostad L., Burhol P. G. Prevalences of endoscopic and histological findings in subjects with and without dyspepsia. BMJ. 1991 Mar 30;302(6779):749–752. doi: 10.1136/bmj.302.6779.749. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Jones R. H., Lydeard S. E., Hobbs F. D., Kenkre J. E., Williams E. I., Jones S. J., Repper J. A., Caldow J. L., Dunwoodie W. M., Bottomley J. M. Dyspepsia in England and Scotland. Gut. 1990 Apr;31(4):401–405. doi: 10.1136/gut.31.4.401. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Jones R., Lydeard S. Prevalence of symptoms of dyspepsia in the community. BMJ. 1989 Jan 7;298(6665):30–32. doi: 10.1136/bmj.298.6665.30. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Kang J. Y., Tay H. H., Wee A., Guan R., Math M. V., Yap I. Effect of colloidal bismuth subcitrate on symptoms and gastric histology in non-ulcer dyspepsia. A double blind placebo controlled study. Gut. 1990 Apr;31(4):476–480. doi: 10.1136/gut.31.4.476. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Knill-Jones R. P. Geographical differences in the prevalence of dyspepsia. Scand J Gastroenterol Suppl. 1991;182:17–24. doi: 10.3109/00365529109109532. [DOI] [PubMed] [Google Scholar]
  13. Levi S., Beardshall K., Swift I., Foulkes W., Playford R., Ghosh P., Calam J. Antral Helicobacter pylori, hypergastrinaemia, and duodenal ulcers: effect of eradicating the organism. BMJ. 1989 Dec 16;299(6714):1504–1505. doi: 10.1136/bmj.299.6714.1504. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. McColl K. E., Fullarton G. M., Chittajalu R., el Nujumi A. M., MacDonald A. M., Dahill S. W., Hilditch T. E. Plasma gastrin, daytime intragastric pH, and nocturnal acid output before and at 1 and 7 months after eradication of Helicobacter pylori in duodenal ulcer subjects. Scand J Gastroenterol. 1991 Mar;26(3):339–346. doi: 10.3109/00365529109025052. [DOI] [PubMed] [Google Scholar]
  15. McColl K. E., Fullarton G. M. Duodenal ulcer pain--the role of acid and inflammation. Gut. 1993 Oct;34(10):1300–1302. doi: 10.1136/gut.34.10.1300. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Prewett E. J., Smith J. T., Nwokolo C. U., Hudson M., Sawyerr A. M., Pounder R. E. Eradication of Helicobacter pylori abolishes 24-hour hypergastrinaemia: a prospective study in healthy subjects. Aliment Pharmacol Ther. 1991 Jun;5(3):283–290. doi: 10.1111/j.1365-2036.1991.tb00029.x. [DOI] [PubMed] [Google Scholar]
  17. Richter J. E. Dyspepsia: organic causes and differential characteristics from functional dyspepsia. Scand J Gastroenterol Suppl. 1991;182:11–16. doi: 10.3109/00365529109109531. [DOI] [PubMed] [Google Scholar]
  18. Tucci A., Corinaldesi R., Stanghellini V., Tosetti C., Di Febo G., Paparo G. F., Varoli O., Paganelli G. M., Labate A. M., Masci C. Helicobacter pylori infection and gastric function in patients with chronic idiopathic dyspepsia. Gastroenterology. 1992 Sep;103(3):768–774. doi: 10.1016/0016-5085(92)90004-i. [DOI] [PubMed] [Google Scholar]
  19. el-Omar E., Penman I., Dorrian C. A., Ardill J. E., McColl K. E. Eradicating Helicobacter pylori infection lowers gastrin mediated acid secretion by two thirds in patients with duodenal ulcer. Gut. 1993 Aug;34(8):1060–1065. doi: 10.1136/gut.34.8.1060. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Gut are provided here courtesy of BMJ Publishing Group

RESOURCES