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Journal of Clinical Pathology logoLink to Journal of Clinical Pathology
. 1985 Aug;38(8):946–953. doi: 10.1136/jcp.38.8.946

Microbial and metabolic profile of achlorhydric stomach: comparison of pernicious anaemia and hypogammaglobulinaemia.

S P Borriello, P J Reed, J M Dolby, F E Barclay, A D Webster
PMCID: PMC499403  PMID: 4031106

Abstract

The microbial flora and some of its metabolites and enzymes in the stomach were compared in patients with achlorhydria, pernicious anaemia, and primary hypogammaglobulinaemia and in patients with dyspepsia with normal gastric acidity. Detailed analysis of the flora of the gastric juice and of the mucosa from the antrum, body, and fundus in six patients with hypogammaglobulinaemia (mean pH 8.2), seven patients with pernicious anaemia (mean pH 7.3), and five patients with dyspepsia (mean pH 1.9) yielded 22 different genera of bacteria, mainly from the patients with achlorhydria, the most common being streptococci, micrococci, staphylococci, veillonella, and lactobacilli. A similar flora was found associated with the mucosa at all three sites. Various metabolites were also looked for. beta Glucoronidase and C14 lipase were found in patients with hypogammaglobulinaemia but not in those with pernicious anaemia or dyspepsia. Volatile fatty acids were not found. Relatively high concentrations of ethanol were found in the patients with hypogammaglobulinaemia compared with those with pernicious anaemia (p = 0.02). Similar concentrations of dimethylamine were found in all three groups, but the concentrations of trimethylamine were much higher in patients with pernicious anaemia and hypogammaglobulinaemia. The high concentrations of some microbial enzymes and ethanol differentiated the group with hypogammaglobulinaemia from the rest, and these may bear some relation to the high incidence of gastric cancer in patients with hypogammaglobulinaemia.

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Selected References

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  1. Autrup H., Harris C. C., Trump B. F. Metabolism of acyclic and cyclic N-nitrosamines by cultured human colon. Proc Soc Exp Biol Med. 1978 Oct;159(1):111–115. doi: 10.3181/00379727-159-40294. [DOI] [PubMed] [Google Scholar]
  2. Barrett E., Lynam G., Trustey S. Gas liquid chromatography for detection of bacteriuria: examination for volatile acidic and neutral compounds. J Clin Pathol. 1978 Sep;31(9):859–865. doi: 10.1136/jcp.31.9.859. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Bode J. C., Rust S., Bode C. The effect of cimetidine treatment on ethanol formation in the human stomach. Scand J Gastroenterol. 1984 Sep;19(6):853–856. [PubMed] [Google Scholar]
  4. Borriello P., Hudson M., Hill M. Investigation of the gastrointestinal bacterial flora. Clin Gastroenterol. 1978 May;7(2):329–349. [PubMed] [Google Scholar]
  5. Dolby J. M., Webster A. D., Borriello S. P., Barclay F. E., Bartholomew B. A., Hill M. J. Bacterial colonization and nitrite concentration in the achlorhydric stomachs of patients with primary hypogammaglobulinaemia or classical pernicious anaemia. Scand J Gastroenterol. 1984 Jan;19(1):105–110. [PubMed] [Google Scholar]
  6. Donnelly L. S., Hartman P. A. Gentamicin-based medium for the isolation of group D streptococci and application of the medium to water analysis. Appl Environ Microbiol. 1978 Mar;35(3):576–581. doi: 10.1128/aem.35.3.576-581.1978. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Drasar B. S., Shiner M., McLeod G. M. Studies on the intestinal flora. I. The bacterial flora of the gastrointestinal tract in healthy and achlorhydric persons. Gastroenterology. 1969 Jan;56(1):71–79. [PubMed] [Google Scholar]
  8. Gray J. D., Shiner M. Influence of gastric pH on gastric and jejunal flora. Gut. 1967 Dec;8(6):574–581. doi: 10.1136/gut.8.6.574. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Hillman K. M., Riordan T., O'Farrell S. M., Tabaqchali S. Colonization of the gastric contents in critically ill patients. Crit Care Med. 1982 Jul;10(7):444–447. doi: 10.1097/00003246-198207000-00005. [DOI] [PubMed] [Google Scholar]
  10. James W. H. Time of fertilisation and sex of infants. Lancet. 1980 May 24;1(8178):1124–1126. doi: 10.1016/s0140-6736(80)91565-2. [DOI] [PubMed] [Google Scholar]
  11. Kinlen L. J., Webster A. D., Bird A. G., Haile R., Peto J., Soothill J. F., Thompson R. A. Prospective study of cancer in patients with hypogammaglobulinaemia. Lancet. 1985 Feb 2;1(8423):263–266. doi: 10.1016/s0140-6736(85)91037-2. [DOI] [PubMed] [Google Scholar]
  12. Koransky J. R., Allen S. D., Dowell V. R., Jr Use of ethanol for selective isolation of sporeforming microorganisms. Appl Environ Microbiol. 1978 Apr;35(4):762–765. doi: 10.1128/aem.35.4.762-765.1978. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Mandel M., Ichinotsubo D., Mower H. Nitroso group exchange as a way of activation of nitrosamines by bacteria. Nature. 1977 May 19;267(5608):248–249. doi: 10.1038/267248a0. [DOI] [PubMed] [Google Scholar]
  14. Nelson D. P., Mata L. J. Bacterial flora associated with the human gastrointestinal mucosa. Gastroenterology. 1970 Jan;58(1):56–61. [PubMed] [Google Scholar]
  15. ROGOSA M., MITCHELL J. A., WISEMAN R. F. A selective medium for the isolation and enumeration of oral and fecal lactobacilli. J Bacteriol. 1951 Jul;62(1):132–133. doi: 10.1128/jb.62.1.132-133.1951. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Ruddell W. S., Axon A. T., Findlay J. M., Bartholomew B. A., Hill M. J. Effect of cimetidine on the gastric bacterial flora. Lancet. 1980 Mar 29;1(8170):672–674. [PubMed] [Google Scholar]
  17. Ruddell W. S., Bone E. S., Hill M. J., Walters C. L. Pathogenesis of gastric cancer in pernicious anaemia. Lancet. 1978 Mar 11;1(8063):521–523. doi: 10.1016/s0140-6736(78)90550-0. [DOI] [PubMed] [Google Scholar]
  18. Snepar R., Poporad G. A., Romano J. M., Kobasa W. D., Kaye D. Effect of cimetidine and antacid on gastric microbial flora. Infect Immun. 1982 May;36(2):518–524. doi: 10.1128/iai.36.2.518-524.1982. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Stockbrugger R. W., Cotton P. B., Eugenides N., Bartholomew B. A., Hill M. J., Walters C. L. Intragastric nitrites, nitrosamines, and bacterial overgrowth during cimetidine treatment. Gut. 1982 Dec;23(12):1048–1054. doi: 10.1136/gut.23.12.1048. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. WILLIS A. T., HOBBS G. Some new media for the isolation and identification of Clostridia. J Pathol Bacteriol. 1959 Apr;77(2):511–521. doi: 10.1002/path.1700770223. [DOI] [PubMed] [Google Scholar]

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