PMID: 9432354Jul 1, 1997Paper

Perturbations in gastric physiology in Helicobacter pylori duodenal ulcer: are they all epiphenomena?

Helicobacter
D Y Graham, M P Dore

Abstract

The Holy Grail of physiological studies in acid secretion has been to identify a specific abnormality in gastroduodenal physiology responsible for the development of duodenal ulcer disease. We review the available data relating duodenal ulcer and Helicobacter pylori infection to perturbations in gastric physiology, especially acid secretion. It is known now that elevated serum pepsinogen levels, reduced inhibition of acid secretion with antral acidification or distention, exaggerated gastrin response to meals or infusion of bombesin or gastric-releasing peptide, exaggerated acid output in response to gastric-releasing peptide, and abnormalities in duodenal bicarbonate secretion in response to instillation of acid are reversible epiphenomena related to the H. pylori infection and are not in themselves responsible for duodenal ulcer disease. H. pylori is inhibited by bile, yet can thrive in the duodenal bulb of duodenal ulcer patients. Glycine-conjugated bile acids are precipitated by acid; thus, any mechanism that would increase the duodenal acid load may remove the inhibitory bile and allow unrestrained growth of H. pylori. These data and speculations offer one possible explanation for why duodenal ulcer occurs in only some peo...Continue Reading

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Jan 1, 1977·Scandinavian Journal of Gastroenterology·M KekkiM Siurala
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Citations

Oct 2, 2002·Lancet·Francis K L Chan, W K Leung
Oct 7, 2006·Current Opinion in Gastroenterology·L M Lichtenberger
Oct 13, 2005·Current Opinion in Gastroenterology·Hong LuDavid Y Graham
Dec 22, 2010·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Luigi GattaCarmelo Scarpignato
Mar 11, 2006·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·David Y GrahamVictor Cardenas
Apr 22, 2016·Helicobacter·Maria P DoreGabrio Bassotti
Apr 5, 2000·Baillière's Best Practice & Research. Clinical Gastroenterology·M P Dore, D Y Graham
Jan 19, 2000·The American Journal of Gastroenterology·D Y Graham, M S Osato

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