Does eradication of Helicobacter pylori reduce hypergastrinaemia during long term therapy with proton pump inhibitors?

Abstract

Objectives: To evaluate the effect of Helicobacter pylori (Hp) eradication therapy on blood gastrin levels in long-term PPI users, since proton pump inhibitors (PPIs) and Helicobacter pylori (Hp) are major causes of hypergastrinaemia. Design: A prospective study. Subjects: Twenty seven Hp (+) patients enrolled in the study. Twenty were given eradication treatment (ET group), and the rest were given symptomatic treatment (ST group). Those who remained Hp (+) after eradication therapy were also added into the ST group. Lansoprazol 30 mg/day was given to both groups for three months thereafter. Results: Fasting and non-fasting blood gastrin levels (FGL and NFGL) were measured initially and one month and four months after treatment. At the end of fourth month, FGL was significantly higher than both initial and first month level (p<0.01) in the ST group. NFGL in this group did not change significantly (p>0.05) after eradication therapy. In the ET group, FGL was significantly higher in the fourth month than the first month (p<0.001) and than the initial level (p<0.05). NFGL was higher, but not statistically in the fourth month than in the first month (p>0.05) and significantly lower than the initial level (p< 0.05) in this group. Conclusion: We suggest that testing for Hp positivity and treating it if detected would be an appropriate approach to avoid hypergastrinaemia, especially in candidate patients for long term PPI treatment.