Neutralization by ammonia cannot explain H. pylori's potentiation of Omeprazole's efficacy

Gillen, Derek; Wirz, Angela A.; Neithercut, W D; Ardill, Jes

doi:10.1016/s0016-5085(98)80538-6

Cited by 2 publications

(2 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“… 23 With proton pump inhibitors given at high doses for several weeks, this phenomenon is very marked 23 , . 24 The aggravation of corpus gastritis may, according to some authors, decrease acid secretion and may consequently lead to an apparently higher effectiveness of omeprazole 21 . However, higher intragastric pH in H. pylori ‐positive subjects compared to H. pylori ‐negative subjects occurs on the first day of treatment with pumaprazole 25 .…”

Section: Discussionmentioning

confidence: 99%

“…19,20 Thus, the improvement in H. pylori gastritis after cure of the infection may lead to an increased number, or to an enhanced sensitivity, of proton pumps but not of H 2 -receptors. Alternatively, two mechanisms may be involved: an aggravation of corpus gastritis leading to a decrease in acid secretion, 6,7,21 or a neutralizing effect of ammonia which disappears after cure of H. pylori infection. 4,5 During administration of acid inhibitors, gastritis improves in the antrum and worsens in the corpus and fundus.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Effects of pumaprazole (BY841), a novel reversible proton pump antagonist, and of omeprazole, on intragastric acidity before and after cure of Helicobacter pylori infection

Martínek¹,

Blum²,

Stolte

et al. 1999

Aliment Pharmacol Ther

View full text Add to dashboard Cite

INTRODUCTIONOmeprazole, an irreversible proton pump inhibitor, produces higher intragastric pH values in the presence of Helicobacter pylori infection than after cure of the infection, both in healthy subjects 1, 2 and in patients with duodenal ulcer disease. 3 The mechanism underlying this effect is still unclear. Two possible explanations have been put forward: (1) decreased production of ammonia or other neutralizing substances after cure of the infection, 4, 5 or (2) development of body gastritis during omeprazole therapy in H. pylori-positive subjects leading to decreased acid secretion. 6,7 Other hypotheses include H. pylori-related changes in acid output, 8±10 SUMMARYBackground: Omeprazole produces a higher intragastric pH in the presence of Helicobacter pylori infection than after cure. Aim: To investigate whether this effect also occurs with pumaprazole (BY841), a reversible proton pump antagonist which, in contrast to omeprazole, does not require activation in the acid compartment of the parietal cell. Methods: In a randomized, crossover, double-blind study, 24-h intragastric pH was measured in 13 H. pylori-positive subjects before and after a 1-week course of omeprazole (20 mg o.d.) or of pumaprazole (100 mg b.d.). The studies were repeated after the infection was cured. Results: In the absence of drug administration, the median 24-h pH values before cure (median 2.0, 90% CI: 1.2±3.2) did not differ from those after cure (median 1.5, 90% CI: 1.3±2.2; P 0.115). The 24-h pH values

show abstract