Abstract
To determine the correlation between histologic features in Helicobacter pylori (H. pylori) -positive patients with hemorrhagic gastric ulcer and the inhibition of gastric acid secretion resulting from continuous intravenous infusion of ranitidine followed by oral administration of omeprazole. Subjects included 27 H. pylori-positive patients with hemorrhagic gastric ulcers (22 men, 5 women; mean age=55.1±13.2 years) . Intra-gastric pH was monitored during continuous intravenous infusion with ranitidine (200 mg per day), and after oral administration of omeprazole for 3 or 4 days. The percentage of time for which the pH was maintained above 3 or 4 (pH 3 holding time and pH 4 holding time, respectively) and the mean pH, were measured. Histologic features in biopsy specimens were graded according to the updated Sydney System. With continuous intravenous ranitidine infusion, pH 3 and pH 4 holding times, as well as the mean pH, were significantly lower for patients with a score of 1 for glandular atrophy in the gastric corpus, than in patients with scores of 0 or 2 and above (P=0.006, P=0.011 and P=0.038, respectively) . Values were also significantly lower for patients with a score of 1 for intestinal metaplasia in the gastric antrum than for patients with scores of 0 or 2 and above (P<0.001, P=0.001 and P=0.001, respectively) . The values during oral administration of omeprazole showed no correlation with histologic features. Inhibition of gastric acid secretion during continuous infusion with ranitidine varies in H. pylori-positive patients with hemorrhagic gastric ulcers and correlates with the degree of atrophy in the gastric mucosa.
