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. 2000 Jan;46(1):20–26. doi: 10.1136/gut.46.1.20

Changes in gastric acid secretion assayed by endoscopic gastrin test before and after Helicobacter pylori eradication

K Iijima 1, S Ohara 1, H Sekine 1, T Koike 1, K Kato 1, S Asaki 1, T Shimosegawa 1, T Toyota 1
PMCID: PMC1727774  PMID: 10601049

Abstract

BACKGROUND—It remains controversial whether or not Helicobacter pylori infection causes altered gastric acid secretion. A novel test for evaluating gastric acid secretion (endoscopic gastrin test; EGT) has recently been developed.
AIM—To investigate by EGT the effects of H pylori eradication on the state of gastric acid secretion in patients with peptic ulcer.
METHODS—Twenty six patients with duodenal ulcer and 33 with gastric ulcer, for all of whom H pylori infection had been documented, were studied by EGT, histological examination of gastric mucosa, and measurement of plasma gastrin levels before and one and seven months after H pylori eradication.
RESULTS—In patients with duodenal ulcer, the mean EGT value before H pylori eradication was higher than that in H pylori negative controls, but it had decreased significantly seven months after the treatment. In contrast, the mean EGT value of patients with gastric ulcer before H pylori eradication was lower than that in H pylori negative controls, but it had increased one month after the treatment; this was followed by a slight decrease at seven months. In both groups, mean EGT values seven months after the treatment were not significantly different from the mean control value.
CONCLUSIONS—The reduced acid secretion in gastric ulcer patients and gastric acid hypersecretion in duodenal ulcer patients were both normalised after the clearance of H pylori.


Keywords: acid secretion; duodenal ulcer; endoscopic gastrin test (EGT); gastric ulcer; Helicobacter pylori

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Figure 1  .

Figure 1  

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Gastritis scores of the antrum (A) and body (B). Before eradication of H pylori, the mean gastritis score of the antrum was not significantly different between the patients with duodenal ulcer (DU) and those with gastric ulcer (GU), but in the gastric body, it was significantly higher in the patients with GU than in those with DU. **p<0.01; NS, not significant.

Figure 2  .

Figure 2  

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Changes in gastritis score in the antrum (A) and body (B) caused by H pylori eradication. One month after the eradication treatment, the mean gastritis score in the antrum had fallen significantly in the patients with duodenal ulcer (DU) as well as in those with gastric ulcer (GU). Between one and seven months, the value decreased significantly only in those with GU. In the gastric body, the mean gastritis score had decreased significantly in both groups at one month. No further decrease was found in either group between one and seven months after the eradication. Vertical bars represent SD of the mean gastritis score. **p<0.01 compared with before.

Figure 3  .

Figure 3  

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Atrophy scores of the antrum (A) and body (B). Before eradication of H pylori, the mean atrophy score of the antrum in patients with gastric ulcer (GU) was significantly higher than that of patients with duodenal ulcer (DU). Similarly, the mean atrophy score of the gastric body was significantly higher in the patients with GU than patients with DU. *p<0.05, **p<0.01.

Figure 4  .

Figure 4  

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Changes in atrophy score in the antrum (A) and body (B) caused by H pylori eradication. After the eradication, the degree of antral or body atrophy did not change significantly in patients with either duodenal ulcer (DU) or gastric ulcer (GU). Vertical bars represent SD of the mean atrophy score.

Figure 5  .

Figure 5  

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Changes in acid secretion in patients with duodenal ulcer (DU) after H pylori eradication. In the H pylori positive patients with DU, the mean EGT value was significantly higher than that of H pylori negative controls. One month after the eradication, no significant change was found in the EGT value, but it had fallen significantly at seven months after the eradication. The value at seven months was not significantly different from the control value. Vertical bars represent SD of the mean. **p<0.01; NS, not significant.

Figure 6  .

Figure 6  

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Changes in acid secretion in patients with gastric ulcer (GU) after H pylori eradication. In the H pylori positive patients with GU, the mean EGT value was significantly lower than that of H pylori negative controls. One month after the eradication, the mean EGT value increased significantly, and then decreased slightly but significantly at seven months. The value at seven months was not significantly different from the control value, but it was still higher than that before eradication. Vertical bars represent SD of the mean. *p<0.05, **p<0.01, NS, not significant.

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