Helicobacter pylori, peptic ulcer disease and inhibition of gastric acid secretion.

Recent studies have been reviewed to establish the possible importance of the interaction between Helicobacter pylori infection and gastric acid secretion. H. pylori infection results in increased gastrin release, but this does not lead to gastric acid hypersecretion and gastrin normalizes after eradication of the infection. An optimal, well-tolerated treatment strategy against H. pylori infection has not yet been clearly defined. One potentially useful approach may be to improve the antibacterial efficacy of antibiotics by effectively regulating gastric acidity. H2-receptor antagonists have no effect against H. pylori infection, while omeprazole (an acid pump inhibitor) appears to have a bacteriostatic action. Combination therapy with omeprazole and amoxycillin has been found to eradicate H. pylori in 50-80% of patients with duodenal ulcer, leading to a significant reduction in ulcer recurrence.