Influence of proton pump inhibitors on gastritis diagnosis and pathologic gastric changes

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dc.contributor.author Nasser, Soumana C.
dc.contributor.author Nasser, Selim M.
dc.contributor.author Slim, Mahmoud
dc.contributor.author Nassif, Jeanette G.
dc.date.accessioned 2016-10-13T10:30:05Z
dc.date.available 2016-10-13T10:30:05Z
dc.date.copyright 2015 en_US
dc.date.issued 2016-10-13
dc.identifier.issn 1007-9327 en_US
dc.identifier.uri http://hdl.handle.net/10725/4594
dc.description.abstract AIM: To investigate the influence of proton pump inhibitors (PPIs) exposure on the diagnosis of Helicobacter pylori (H. pylori) gastritis and intestinal metaplasia. METHODS: Chronic PPI use is associated with masking of H. pylori infection. Patients with H. pylori infection are predisposed to gastric and duodenal ulcers, and long-term infection with this organism has been associated with gastric mucosal atrophy and serious long-term complications, such as gastric lymphoma and adenocarcinoma. Three hundred patients diagnosed with gastritis between January 2008 and April 2010 were included in our study. The computerized medical database of these patients was reviewed retrospectively in order to assess whether the type of gastritis diagnosed (H. pylori vs non-H. pylori gastritis) is influenced by PPI exposure. H. pylori density was graded as low, if corresponding to mild density following the Updated Sydney System, or high, if corresponding to moderate or severe densities in the Updated Sydney System. RESULTS: Patients were equally distributed between males and females with a median age at the time of diagnosis of 50 years old (range: 20-87). The histological types of gastritis were classified as H. pylori gastritis (n = 156, 52%) and non-H. pylori gastritis (n = 144, 48%). All patients with non-H. pylori gastritis had inactive chronic gastritis. Patients with no previous PPI exposure were more likely to be diagnosed with H. pylori gastritis than those with previous PPI exposure (71% vs 34.2%, P < 0.001). Intestinal metaplasia was more likely to be detected in the latter patients (1.4% vs 6.5%, P = 0.023). Multivariate analysis has also demonstrated that in the presence of previous PPI exposure (OR = 0.217, 95%CI: 0.123-0.385), GERD (OR = 0.317, 95%CI: 0.132-0.763, P = 0.01), alcohol intake (OR = 0.396, 95%CI: 0.195-0.804, P = 0.01), the detection of H. pylori was less likely. Chronic use of PPIs may mask H. pylori infections promoting the diagnosis of non-H. pylori gastritis and leads to a significant drop in H. pylori densities and to an increased risk of intestinal metaplasia. CONCLUSION: The use of PPIs masks H. pylori infection, promotes the diagnosis of non-H. pylori inactive chronic gastritis diagnosis, and increases the incidence of intestinal metaplasia. en_US
dc.language.iso en en_US
dc.title Influence of proton pump inhibitors on gastritis diagnosis and pathologic gastric changes en_US
dc.type Article en_US
dc.description.version Published en_US
dc.author.school SOP en_US
dc.author.school SOM
dc.author.idnumber 199231640 en_US
dc.author.idnumber 200804624
dc.author.department Pharmacy Practice Department en_US
dc.description.embargo N/A en_US
dc.relation.journal World of Journal Gastroenterology en_US
dc.journal.volume 21 en_US
dc.journal.issue 15 en_US
dc.article.pages 4599-4606 en_US
dc.keywords Gastritis en_US
dc.keywords Diagnosis en_US
dc.keywords Helicobacter pylori en_US
dc.keywords Proton pump inhibitors en_US
dc.keywords Social factors en_US
dc.identifier.doi http://dx.doi.org/10.3748/wjg.v21.i15.4599 en_US
dc.identifier.ctation Nasser, S. C., Slim, M., Nassif, J. G., & Nasser, S. M. (2015). Influence of proton pump inhibitors on gastritis diagnosis and pathologic gastric changes. World Journal of Gastroenterology: WJG, 21(15), 4599. en_US
dc.author.email soumana.nasser@lau.edu.lb en_US
dc.author.email selim.nasser@lau.edu.lb
dc.identifier.tou http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.php en_US
dc.identifier.url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4402307/ en_US

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