Effects of acid suppression on microbial flora of upper gut

Decreased acid secretion, due to therapy or disease, predisposes to increased bacterial counts in gastric juice. As bacterial numbers increase, the number of nitrate-reducing strains and the concentration of luminal nitrite usually also increase. However, there is controversy (mainly because of assa...

Full description

Saved in:
Bibliographic Details
Published in:Digestive diseases and sciences 1995-02, Vol.40 (2), p.81S-95S
Main Authors: YEOMANS, N. D, BRIMBLECOMBE, R. W, ELDER, J, HEATLEY, R. V, MISIEWICZ, J. J, NORTHFIELD, T. C, POTTAGE, A
Format: Article
Language:English
Subjects:
Antacids - pharmacology
Biological and medical sciences
Digestive system
Gastric Acid - metabolism
Gastric Juice - microbiology
Histamine H2 Antagonists - pharmacology
Humans
Intestine, Small - microbiology
Medical sciences
Nitrates - metabolism
Pharmacology. Drug treatments
Stomach - microbiology
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Decreased acid secretion, due to therapy or disease, predisposes to increased bacterial counts in gastric juice. As bacterial numbers increase, the number of nitrate-reducing strains and the concentration of luminal nitrite usually also increase. However, there is controversy (mainly because of assay problems) about whether decreased acid increases generation of N-nitroso compounds: these may be produced by acid or by bacterial catalysis, and the relative contributions of each are still uncertain. Other potentially important factors include ascorbate secretion (can prevent nitrite conversion to nitroso compounds) and the particular spectrum of nitroso compounds produced. Nitrosation of several histamine H2-receptor antagonists has been demonstrated experimentally, but under conditions that are very unlikely to be encountered clinically. Some acid suppressant therapies have been claimed to aid eradication of Helicobacter pylori, but more work is needed to evaluate this. If ulcer treatment regimens do not also address eradication of H. pylori (when present), gastritis will progress, and the recently documented association between H. pylori and gastric carcinoma needs to be considered. Enteric flora probably also increase if acid secretion is markedly reduced: this does not appear to have nutritional consequences but probably reduces the resistance to occasional infections, of which cholera is the best documented.
ISSN:0163-2116
1573-2568
DOI:10.1007/BF02214873