Early events in proton pump inhibitor-associated exacerbation of corpus gastritis

Aliment Pharmacol Ther. 2003 Jan;17(2):193-200. doi: 10.1046/j.1365-2036.2003.01400.x.


Background: Antisecretory therapy may exacerbate Helicobacter pylori corpus gastritis. The rate and mechanism(s) remain unknown.

Aim: To investigate the early events in proton pump inhibitor therapy on antral and corpus H. pylori gastritis.

Methods: Nine H. pylori-infected volunteers underwent gastric biopsy with jumbo forceps for culture and histology. Histology was scored in the range 0-5 using a visual analogue scale. The depth of inflammation in gastric pits was scored in the range 1-3 (superficial or less than one-third, one-third to two-thirds and greater than two-thirds of the gastric pit, respectively). Tissue interleukin-1 beta and interleukin-8 levels were measured by enzyme-linked immunoabsorbent assay. Omeprazole, 20 mg b.d., was given for 6.5 days and biopsies were repeated on day 7.

Results: Proton pump inhibitor therapy resulted in a fall in H. pylori density in the antrum and corpus. Inflammation and tissue levels of interleukin-8 and interleukin-1 beta decreased in the antrum and increased in the corpus mucosa. There was a significant increase in the depth of inflammation to include the proliferative zone in the corpus.

Conclusions: Within 1 week of starting proton pump inhibitor therapy, there was a marked extension of corpus inflammation into the gastric pit and an increase in corpus mucosal interleukin-1 beta and interleukin-8 levels. H. pylori eradication should be considered for all patients receiving long-term antisecretory therapy.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Anti-Ulcer Agents / adverse effects*
  • Female
  • Gastritis / chemically induced*
  • Gastritis / microbiology
  • Helicobacter Infections*
  • Helicobacter pylori*
  • Humans
  • Male
  • Omeprazole / adverse effects*
  • Proton Pump Inhibitors*


  • Anti-Ulcer Agents
  • Proton Pump Inhibitors
  • Omeprazole