Infective gastroenteritis and its relationship to reduced gastric acidity

Cook, G.C.

doi:10.3109/00365528509093751

Cited by 75 publications

(37 citation statements)

References 43 publications

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“…Although Giardiasis is the most common protozoal infection of the small intestine worldwide, gastric infection is very rare, with less than 100 cases reported in the literature. Because Giardia lamblia is acid-sensitive, survival in the stomach is only possible with reduced acid levels, with more than 50% of patients with intestinal Giardiasis having some form of hypochlorhydria [108]. There have been rare case reports of patients developing gastric Giardiasis after being treated with PPIs but no large-scale studies have been conducted [109,110].…”

Section: Parasitic Infectionsmentioning

confidence: 99%

Adverse Effects of Long-Term Proton Pump Inhibitor Therapy

2011

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Proton pump inhibitors have an excellent safety profile and have become one of the most commonly prescribed class of drugs in primary and specialty care. Long-term, sometimes lifetime, use is becoming increasingly common, often without appropriate indications. This paper is a detailed review of the current evidence on this important topic, focusing on the potential adverse effects of long-term proton pump inhibitor use that have generated the greatest concern: B12 deficiency; iron deficiency; hypomagnesemia; increased susceptibility to pneumonia, enteric infections, and fractures; hypergastrinemia and cancer; drug interactions; and birth defects. We explain the pathophysiological mechanisms that may underlie each of these relationships, review the existing evidence, and discuss implications for clinical management. The benefits of proton pump inhibitor use outweigh its risks in most patients. Elderly, malnourished, immune-compromised, chronically ill, and osteoporotic patients theoretically could be at increased risk from long-term therapy.

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Section: Parasitic Infectionsmentioning

confidence: 99%

Adverse Effects of Long-Term Proton Pump Inhibitor Therapy

2011

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“…The prevalence of achlorhydria is gener ally high in poorer underdeveloped nations, where it is closely associated with malnutri tion [13][14][15]. In one study [14] of 14 mal nourished children, 9 had a marked reduc tion in basal acid output and all had reduced peak acid output to pentagastrin.…”

Section: Consequences Of Achlorhydriamentioning

confidence: 99%

“…This would then favour superadded in fection with enteric pathogens. However in view of the problems in differentiating a cause-or-effect relationship between parasite infection and reduced gastric acidity [15], good longitudinal studies will be required be fore this hypothesis can be verified.…”

Section: Consequences Of Achlorhydriamentioning

confidence: 99%

Spontaneous Hypochlorhydria in Man: Possible Causes and Consequences

Howden

Hunt²

1986

Dig Dis

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“…From these observations it has been concluded that the presence of gastric acid has important implications for the survival of pathogens that have entered the GI tract. Suppression of gastric acid secretion may allow infection to occur following ingestion of a smaller number of inoculated pathogens such as Salmonella enterica or Listeria monocytogenes [131, 137, 151]. There is some evidence to support an increased risk of parasitic infections under conditions of reduced acid secretion [151,152,153].…”

Section: Gastric Acid Gi Flora and Infectionmentioning

confidence: 99%

“…Suppression of gastric acid secretion may allow infection to occur following ingestion of a smaller number of inoculated pathogens such as Salmonella enterica or Listeria monocytogenes [131, 137, 151]. There is some evidence to support an increased risk of parasitic infections under conditions of reduced acid secretion [151,152,153]. Whether there is an increased risk of viral or bacterial gastroenteritis in patients receiving gastric-acid-suppression therapy remains controversial [154].…”

Section: Gastric Acid Gi Flora and Infectionmentioning

confidence: 99%

Do We Need Gastric Acid?

et al. 2008

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Evidence from comparative anatomy and physiology studies indicates that gastric acid secretion developed during the evolution of vertebrates approximately 350 million years ago. The cellular mechanisms that produce gastric acid have been conserved over the millennia and therefore proton pump inhibitors have pharmacological effects in almost all relevant species. These observations suggest that gastric acid provides an important selective advantage; however, in modern-day humans the need for gastric acid can be questioned in light of the widespread use of safe and effective pharmacologic acid suppression. The Kandahar Working Group addressed questions concerning the need, production and effects of gastric acid, specifically: (1) motility in the upper gastrointestinal (GI) tract; (2) neuroendocrine factors; (3) digestive and mucosal processes; (4) microbiology, and (5) central processes and psychological involvement. We addressed each topic with the individual models available to answer our questions including animal versus human studies, pharmacologic, surgical as well as pathophysiologic states of acid suppression.

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Infective gastroenteritis and its relationship to reduced gastric acidity

Cited by 75 publications

References 43 publications

Adverse Effects of Long-Term Proton Pump Inhibitor Therapy

Adverse Effects of Long-Term Proton Pump Inhibitor Therapy

Spontaneous Hypochlorhydria in Man: Possible Causes and Consequences

Do We Need Gastric Acid?

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