The Impact of Gastric Juice PH on the Intraluminal Therapy for Infection

Overview

Journal J Clin Med

Specialty General Medicine

Date 2020 Jun 18

PMID 32545856

Citations 5

Authors

Yu-Chio Wang

Yen-Po Chen

Cheng-Yu Ho

Ting-Wen Liu

Cheng-Hsin Chu

Horng-Yuan Wang

Tai-Cherng Liou

Affiliations

Soon will be listed here.

Abstract

Background: can be topically eradicated in stomach lumen on endoscopic examination. The procedures of intraluminal therapy for infection (ILTHPI) include the control of intragastric pH, mucolytic irrigation of the gastric mucosal surface, and a single-dose medicament containing antimicrobial agents.

Aims: To detect gastric juice pH and evaluate its impact on the success rate of ILTHPI.

Methods: We enrolled 324 patients with upper abdominal discomfort for endoscopic examinations. Among them, 13C-urea breath test was positive in 218 patients, where 100 underwent ILTHPI, and negative in 106. All patients had their gastric juice pH detected and set into three ranges, including normal acidity (pH < 4.0), low-level hypoacidity (pH 4.0-5.5), and high-level hypoacidity (pH ≥ 6.0). The impact of gastric juice pH on the success rate of ILTHPI was evaluated.

Results: Distribution of pH level showed no significant difference between two groups of -infected patients ( = 0.942). The eradication rate of ILTHPI is significantly lower in patients with gastric juice pH below 4 ( < 0.001).

Conclusions: Detection of gastric juice pH in ILTHPI is extremely important. Rapid control of stomach pH at or above 4 for patients prior to ILTHPI is strongly recommended. (NCT03124420).

Citing Articles

Comparison of the Efficacy of Two-Week Vonoprazan Versus Lansoprazole-Based Quadruple Sequential Antibiotic Therapy in Eradicating Helicobacter pylori Infection: A Non-randomized Clinical Trial.

Nizam A, Chaudary Z, Ahmad S, Nawaz N, Riaz Z, Shehzad A Cureus. 2024; 16(1):e52758.

PMID: 38389593 PMC: 10882247. DOI: 10.7759/cureus.52758.

Current paradigms in the management of refractory Helicobacter pylori infection.

Jearth V, Panigrahi M Indian J Gastroenterol. 2023; 42(6):766-779.

PMID: 37737326 DOI: 10.1007/s12664-023-01448-3.

Intraluminal Therapy for Infection-Comparison of Medicament Containing Tetracycline, Metronidazole, and Bismuth versus Amoxicillin, Metronidazole, and Clarithromycin: A Randomized Controlled Study.

Liu T, Chen Y, Ho C, Chen M, Wang H, Shih S Biomedicines. 2023; 11(4).

PMID: 37189702 PMC: 10135832. DOI: 10.3390/biomedicines11041084.

Comparison of Vonoprazan and Amoxicillin Dual Therapy with Standard Triple Therapy with Proton Pump Inhibitor for Helicobacter Pylori eradication: A Randomized Control Trial.

Zuberi B, Ali F, Rasheed T, Bader N, Hussain S, Saleem A Pak J Med Sci. 2022; 38(4Part-II):965-969.

PMID: 35634610 PMC: 9121978. DOI: 10.12669/pjms.38.4.5436.

Factors Affecting the Intraluminal Therapy for Infection.

Ho C, Liu T, Lin Y, Chen Y, Chen M, Wang H Microorganisms. 2022; 10(2).

PMID: 35208870 PMC: 8876938. DOI: 10.3390/microorganisms10020415.

References

Sugimoto M, Furuta T, Shirai N, Kodaira C, Nishino M, Ikuma M . Evidence that the degree and duration of acid suppression are related to Helicobacter pylori eradication by triple therapy. Helicobacter. 2007; 12(4):317-23. DOI: 10.1111/j.1523-5378.2007.00508.x. View

Bell N, Hunt R . Time to maximum effect of lansoprazole on gastric pH in normal male volunteers. Aliment Pharmacol Ther. 1996; 10(6):897-904. DOI: 10.1046/j.1365-2036.1996.103242000.x. View

Leal J, Smyth H, Ghosh D . Physicochemical properties of mucus and their impact on transmucosal drug delivery. Int J Pharm. 2017; 532(1):555-572. PMC: 5744044. DOI: 10.1016/j.ijpharm.2017.09.018. View

Valenzuela M, Cerda O, Toledo H . Overview on chemotaxis and acid resistance in Helicobacter pylori. Biol Res. 2003; 36(3-4):429-36. DOI: 10.4067/s0716-97602003000300014. View

Atuma C, Strugala V, Allen A, Holm L . The adherent gastrointestinal mucus gel layer: thickness and physical state in vivo. Am J Physiol Gastrointest Liver Physiol. 2001; 280(5):G922-9. DOI: 10.1152/ajpgi.2001.280.5.G922. View

Cui Y, Zhou K, Strugatsky D, Wen Y, Sachs G, Zhou Z . pH-dependent gating mechanism of the urea channel revealed by cryo-EM. Sci Adv. 2019; 5(3):eaav8423. PMC: 6426461. DOI: 10.1126/sciadv.aav8423. View

Merki H, Fimmel C, Walt R, Harre K, Rohmel J, Witzel L . Pattern of 24 hour intragastric acidity in active duodenal ulcer disease and in healthy controls. Gut. 1988; 29(11):1583-7. PMC: 1433850. DOI: 10.1136/gut.29.11.1583. View

Fan H, Wang J, Yan G, Huo X, Mu L, Chu J . Increasing gastric juice pH level prior to anti-Helicobacter pylori therapy may be beneficial to the healing of duodenal ulcers. Exp Ther Med. 2013; 5(3):912-916. PMC: 3570246. DOI: 10.3892/etm.2013.880. View

Allen A, Flemstrom G . Gastroduodenal mucus bicarbonate barrier: protection against acid and pepsin. Am J Physiol Cell Physiol. 2004; 288(1):C1-19. DOI: 10.1152/ajpcell.00102.2004. View

10.

Rektorschek M, Weeks D, Sachs G, Melchers K . Influence of pH on metabolism and urease activity of Helicobacter pylori. Gastroenterology. 1998; 115(3):628-41. DOI: 10.1016/s0016-5085(98)70142-8. View

11.

Savoldi A, Carrara E, Graham D, Conti M, Tacconelli E . Prevalence of Antibiotic Resistance in Helicobacter pylori: A Systematic Review and Meta-analysis in World Health Organization Regions. Gastroenterology. 2018; 155(5):1372-1382.e17. PMC: 6905086. DOI: 10.1053/j.gastro.2018.07.007. View

12.

SAMLOFF I . Peptic ulcer: the many proteinases of aggression. Gastroenterology. 1989; 96(2 Pt 2 Suppl):586-95. DOI: 10.1016/s0016-5085(89)80054-x. View

13.

Sung J, Kim N, Lee J, Hwang Y, Kim H, Chung J . Associations among Gastric Juice pH, Atrophic Gastritis, Intestinal Metaplasia and Infection. Gut Liver. 2017; 12(2):158-164. PMC: 5832340. DOI: 10.5009/gnl17063. View

14.

Lai S, Wang Y, Hanes J . Mucus-penetrating nanoparticles for drug and gene delivery to mucosal tissues. Adv Drug Deliv Rev. 2009; 61(2):158-71. PMC: 2667119. DOI: 10.1016/j.addr.2008.11.002. View

15.

Hessey S, Spencer J, Wyatt J, Sobala G, Rathbone B, Axon A . Bacterial adhesion and disease activity in Helicobacter associated chronic gastritis. Gut. 1990; 31(2):134-8. PMC: 1378366. DOI: 10.1136/gut.31.2.134. View

16.

Croxen M, Sisson G, Melano R, Hoffman P . The Helicobacter pylori chemotaxis receptor TlpB (HP0103) is required for pH taxis and for colonization of the gastric mucosa. J Bacteriol. 2006; 188(7):2656-65. PMC: 1428400. DOI: 10.1128/JB.188.7.2656-2665.2006. View

17.

Marcus E, Inatomi N, Nagami G, Sachs G, Scott D . The effects of varying acidity on Helicobacter pylori growth and the bactericidal efficacy of ampicillin. Aliment Pharmacol Ther. 2012; 36(10):972-9. PMC: 3474890. DOI: 10.1111/apt.12059. View

18.

Cheng A, Sheng W, Liou J, Wang H, Wu M, Lin J . Comparative in vitro antimicrobial susceptibility and synergistic activity of antimicrobial combinations against Helicobacter pylori isolates in Taiwan. J Microbiol Immunol Infect. 2012; 48(1):72-9. DOI: 10.1016/j.jmii.2012.08.021. View

19.

Johansson M, Sjovall H, Hansson G . The gastrointestinal mucus system in health and disease. Nat Rev Gastroenterol Hepatol. 2013; 10(6):352-61. PMC: 3758667. DOI: 10.1038/nrgastro.2013.35. View

20.

Cao X, Bansil R, Bhaskar K, Turner B, Lamont J, Niu N . pH-dependent conformational change of gastric mucin leads to sol-gel transition. Biophys J. 1999; 76(3):1250-8. PMC: 1300105. DOI: 10.1016/S0006-3495(99)77288-7. View