Journal of Gastroenterology

, Volume 46, Issue 5, pp 612–619

Gastric acid secretion level modulates the association between Helicobacter pylori infection and low-dose aspirin-induced gastropathy

  • Katsunori Iijima
  • Nobuyuki Ara
  • Yasuhiko Abe
  • Tomoyuki Koike
  • Wataru Iwai
  • Kaname Uno
  • Naoki Asano
  • Akira Imatani
  • Shuichi Ohara
  • Tooru Shimosegawa
Original Article—Alimentary Tract

Abstract

Background

The relative contribution of gastric acid secretion and Helicobacter pylori infection to low-dose aspirin-induced gastropathy remains to be clarified. This is partly because the capability of the infection to modify gastric acid secretion complicates the interaction. The aim of this study was to estimate the association of aspirin-induced mucosal injury, as well as H. pylori infection, with gastric acid output.

Methods

A total of 186 male outpatients, comprising 60 aspirin takers, on 100 mg of enteric-coated aspirin daily and 126 non-aspirin takers were prospectively enrolled in this study. Gastrin-stimulated acid output was estimated by the endoscopic gastrin test. The grade of gastric mucosal injury was assessed endoscopically according to the modified Lanza score. Multiple logistic regression analyses were used to adjust for potential confounders.

Results

The gastric acid secretion level, with an odds ratio (OR) (95% confidence interval [CI]) of 10.5 (3.0–36.9) and aspirin administration, with an OR (95% CI) of 7.4 (3.0–18.3) were independently associated with gastric mucosal injury, and the co-existence of both factors greatly elevated the risk of mucosal injury, with an OR (95% CI) of 77.0 (13.5–440.0). H. pylori infection, itself, did not show any significant effect on the aspirin-induced mucosal injury after adjusting for gastric acid secretion.

Conclusions

This study has demonstrated that aspirin-induced gastropathy is directly associated with gastric acid secretion. In addition, it also suggested that the gastric acid secretion level modulates the association between H. pylori infection and aspirin-induced gastropathy.

Keywords

Aspirin Gastric acid secretion Gastric mucosal injury H. pylori 

Abbreviations

CI

Confidence interval

EGT

Endoscopic gastrin test

GI

Gastrointestinal

MLS

Modified Lanza score

NSAID

Non-steroidal anti-inflammatory drug

OR

Odds ratio

PPI

Proton pump inhibitor

Supplementary material

535_2011_385_MOESM1_ESM.doc (44 kb)
Supplementary material 1 (DOC 43 kb)

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Copyright information

© Springer 2011

Authors and Affiliations

  • Katsunori Iijima
    • 1
  • Nobuyuki Ara
    • 1
  • Yasuhiko Abe
    • 1
  • Tomoyuki Koike
    • 1
  • Wataru Iwai
    • 1
  • Kaname Uno
    • 1
  • Naoki Asano
    • 1
  • Akira Imatani
    • 1
  • Shuichi Ohara
    • 1
  • Tooru Shimosegawa
    • 1
  1. 1.Division of GastroenterologyTohoku University Graduate School of MedicineSendaiJapan

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