Abstract
In order to examine the effect ofHelicobacter pylori colonization on the gastric mucus microclimate, antral juxtamucosal pH was measured in 47 patients attending as out patients for upper gastrointestinal endoscopy. The mean pH in 28 patients negative forH. pylori was 6.40±0.24 compared to 6.88±0.16 in 19 patients who were positive (P< 0.0001). In six of seven patients who agreed to a second study,H. pylori was eradicated and the mean pH fell from 6.81±0.17 to 6.08±0.16 (P<0.001). The pH remained high in the one patient who remained positive (6.8 and 7.0). This study provides the firstin vivo evidence thatH. pylori can increase the antral juxtamucosal pH and suggests that ammonia production by the organism is capable of altering gastric mucus microclimate to impair the normal negative feedback controlling gastrin release. This observation may explain the coexistence of relative hypergastrinemia andH. pylori colonization in duodenal ulcer patients.
Similar content being viewed by others
References
Coghland JG, Gilligan D, Humphries H, et al:Campylobacter pylori and recurrence of duodenal ulcers; a 12 month follow up study. Lancet 2:1109–1111, 1988
Marshall BJ, Goodwin CS, Warren JE, et al: Prospective double blind trial of duodenal ulcer relapse after eradication ofCampylobacter pylori Lancet 2:1467–1469, 1988
Dooley CP, Cohen H: The clinical significance ofCampylobacter pylori. Ann Intern Med 108:70–79, 1988
Taylor IL, Calam J, Rutter J, et al: Family studies of hypergastrinaemic, hyperpepsinogenemic I duodenal ulcer disease. Ann Intern Med 95:421–425, 1981
Levi S, Beardshall K, Haddad G, Playford R, Ghosh P, Calam J:Campylobacter pylori and duodenal ulcers: The gastrin link. Lancet 1:1167–1168, 1989
Quigley EMM, and Turnberg LA: pH of the microclimate lining human gastric and duodenal mucosain vivo. Gastroenterology 1876–1884, 1987
Marshall BJ, Barrett LJ, Prakash C: Urea protectsHelicobacter (Campylobacter) pylori from the bactericidal effect of acid. Gastroenterology 99:697–702, 1990
Smoot DT, Mobley HLT, Chippendale GR, Lewison JF, Resau JH.Helicobacter pylori urease activity is toxic to human gastric epithelial cells. Infect Immun 58:1992–1994, 1990
Sidebotham RL, Baron JH: Hypothesis:Helicobacter pylori, urease, mucus and gastric ulcer. Lancet 1:193–195, 1990
Neithercut WD, Milne A, Chittajalla RS, El Nujumi AM, McColl KE: Accurate determination ofH. pylori status at endoscopy by measurement of the urea/ammonia ratio in gastric juice. Gut 31:A1177, 1990
McKinlay AW, Upadhyay R, Gemmell CG, Russell RI:Helicobacter pylori: Bridging the credibility gap. Gut 31:940–945, 1990
Smith JTL, Pounder RE, Nwokolo CU, et al: Inappropriate hypergastrinaemia in asymptomatic healthy subjects infected withHelicobacter pylori. Gut 31:522–525, 1990
Peters NM, Feldman M, Walsh JH, Richardson CT: Effect of gastric alkalinization on serum, gastrin concentrations in humans. Gastroenterology, 85:35–39, 1983
Levi S, Beardshall K, Swift I, et al: AntralHelicobacter pylori, hypergastrinaemia and duodenal ulcers: Effect of eradicating the organism. Br Med J 299:1504–1505, 1989
McColl KEL, Fullarton GM, Nujami AMI, MacDonald AM, Brown IL, Hilditch TE: Lowered gastrin and gastric acidity after eradication ofCampylobacter pylori in duodenal ulcer. Lancet 2:499–500, 1989
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Kelly, S.M., Crampton, J.R. & Hunter, J.O. Helicobacter pylori increases gastric antral juxtamucosal pH. Digest Dis Sci 38, 129–131 (1993). https://doi.org/10.1007/BF01296784
Received:
Revised:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01296784