Search resultsHypochlorhydria induced by a proton pump inhibitor leads to intragastric microbial production of acetaldehyde from ethanol
Title
Hypochlorhydria induced by a proton pump inhibitor leads to intragastric microbial production of acetaldehyde from ethanol
Publication type
Journal Article
Year of Publication
2000
Authors
Journal
Alimentary Pharmacology and Therapeutics
Volume
14
Issue
11
Pagination
1511 - 1518
Date published
2000
ISBN
02692813 (ISSN)
Keywords
2-Pyridinylmethylsulfinylbenzimidazoles, acetaldehyde, achlorhydria, Adult, aerobic bacterium, alcohol, alcohol consumption, anaerobic bacterium, Anti-Ulcer Agents, article, Bacteria, bacterial overgrowth, clinical article, correlation function, Ethanol, Gastric Juice, Gastric Mucosa, human, Humans, Hydrogen-Ion Concentration, lansoprazole, male, Omeprazole, priority journal, proton pump inhibitor, Proton Pumps, stomach juice, stomach pH, volunteer
Abstract
Background: Acetaldehyde, produced locally in the digestive tract, has recently been shown to be carcinogenic in humans. Aim: To examine the effect of iatrogenic hypochlorhydria on intragastric acetaldehyde production from ethanol after a moderate dose of alcohol, and to relate the findings to the changes in gastric flora. Methods: Eight male volunteers ingested ethanol 0.6 g/kg b.w. The pH, acetaldehyde level and microbial counts of the gastric juice were then determined. The experiment was repeated after 7 days of lansoprazole 30 mg b.d. Results: The mean (± S.E.M.) pH of the gastric juice was 1.3 ± 0.06 and 6.1 ± 0.5 (P < 0.001) before and after lansoprazole, respectively. This was associated with a marked overgrowth of gastric aerobic and anaerobic bacteria (P < 0.001), by a 2.5-fold (P = 0.003) increase in gastric juice acetaldehyde level after ethanol ingestion and with a positive correlation (r=0.90, P < 0.001) between gastric juice acetaldehyde concentration and the count of aerobic bacteria. Conclusions: Treatment with proton pump inhibitors leads to hypochlorhydria, which associates with intragastric overgrowth of aerobic bacteria and microbially-mediated acetaldehyde production from ethanol. Since acetaldehyde is a local carcinogen in the concentrations found in this study, long-term use of gastric acid secretory inhibitors is a potential risk-factor for gastric and cardiac cancers.