Occurrence and significance of gastric colonization during acid-inhibitorytherapy

Authors
Citation
C. Williams, Occurrence and significance of gastric colonization during acid-inhibitorytherapy, BEST PR RES, 15(3), 2001, pp. 511-521
Citations number
83
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Gastroenerology and Hepatology
Journal title
BEST PRACTICE & RESEARCH IN CLINICAL GASTROENTEROLOGY
ISSN journal
1521-6918 → ACNP
Volume
15
Issue
3
Year of publication
2001
Pages
511 - 521
Database
ISI
SICI code
1521-6918(200106)15:3<511:OASOGC>2.0.ZU;2-G
Abstract
There are now a wide variety of drugs available that are able profoundly to reduce the production of gastric acid. These drugs are currently widely pr escribed for the treatment of peptic ulceration and gastro-oesophageal refl ux disease. One of the main functions of gastric acid is to kill ingested b acteria. Colonization of the gastric lumen occurs in patients on antisecret ory medication, the degree of bacterial overgrowth depending upon the degre e of elevation of the pH. There have been concerns that these bacteria may produce carcinogenic nitrosamines and increase the risk of gastric cancer, but there is at present no definitive evidence in support of this. A profou nd suppression of gastric acid may also facilitate the colonization of the upper small intestine, leading to deconjugation of the bile salts and malab sorption. There is some evidence that profound gastric acid suppression may decrease the number of ingested pathogens required to produce enteric dise ase. This chapter discusses these potential bacterial complications of ther apeutic acid suppression and the evidence for them.