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Re: more GERD tangent » Quintal

Posted by Larry Hoover on December 21, 2008, at 13:52:24

In reply to Re: GERD tangent » Larry Hoover, posted by Quintal on December 12, 2008, at 19:28:43

Medical concensus has been changing about the influence/interaction between GERD and Helicobacter pylori. I had the older perspective, and I want to correct what I posted earlier.

It has been found that Hp infection actually improves responsiveness to proton pump inhibitor drugs, probably due to chemicals released by the bacteria themselves, which have the effect of reducing acid rebound as the drug effect wanes between doses. It's not clear if antibiotic treatment is required to eradicate HP, either, as the PPI drugs also inhibit an essential biochemical pathway in the bacteria. So, perhaps the big issue is how the drug controls symptoms. Or not.

A second concern, though, may be more important. I earlier mentioned gastrin, the hormone that the body secretes that induces hydrochloric acid release into the stomach. Proton pump inhibitors lead to chronic hypergastrinaemia (high blood concentrations of gastrin), which is associated with a significantly increased risk of upper GI tract cancers, especially carcinoid and those of the stomach wall. The association is not proven, but primary (genetic) hypergastrinaemia is associated with neoplasm. It's possible that people just haven't been treated with these drugs for long enough, yet, for any such association to come to light.

Regards,
Lar

 

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poster:Larry Hoover thread:866984
URL: http://www.dr-bob.org/babble/20081214/msgs/870071.html