Only registered users are allowed to post. To register, please click here

Should you have any problem in posting, registering, or login, please do not hesitate to contact the admin at Marshall.centre(at)gmail(dot)com. In the subject, please use "Help needed for www.helico.com"

Advertisement is not allowed. While we encourage discussion, please try not to promote your website, goods, or unproven treatment here.

This is a non-profit website. We will try our best to help anyone that has question about H. pylori and their treatment. We shall provide the most accurate answer about H. pylori. You can help us by clicking here to keep this forum alive.

Some useful guides
How to post in the forum?
Management of Helicobacter pylori infection—the Maastricht V/Florence Consensus Report
The 5th Chinese Helicobacter treatment consensus
How long should I wait before doing follow up breath/stool test?

If you are confirmed with H. pylori, in your convenient time, please help us with the symptoms survey that you are experiencing.
Symptoms survey
(contributed by frostyfeet)


此网站免费然您阅读。若想分享心得或提问,请先注册
若有困难注册,请联络站长 Marshall.centre(at)gmail(dot)com。标题请用 "Help needed for www.helico.com"
此网站不允许打广告。我们欢迎任何的讨论。但尽量不要推销没医学根据的网站,商品或治疗方案。
此网站是非盈利网站。我们会尽最大能力提供任何有关幽门螺杆菌的讯息。您的捐款可以让我们继续帮助更多的病人。

指南
如何贴文?
欧洲幽门螺杆菌治疗共识 5
第五次全国幽门螺杆菌感染处理共识报告
用药后,多久以后可以再做吹气测试?

Questions on PPIs, risk, and stress

New things in the forums might be highlighted here. Take a look at the avatars! Get yourself one, there are hundreds to choose from.

Moderators: barjammar, Toni

Post Reply
ankiwo72
Posts: 73
Joined: Fri May 17, 2019 2:45 am

Questions on PPIs, risk, and stress

Post by ankiwo72 »

Dear Helico expert,

In the news this past year there have been many articles revolving around the risks of long-term PPI use. Hypothetically speaking, if someone (like me or anyone else here) were infected with an uncurable H. Pylori strain, is it better for that person to go on long-term PPI use which can increase gastric cancer risk (and other health issues), or not to treat with PPIs and increase gastric cancer risk from untreated gastritis/chronic inflammation? In other words, which is the lesser of the evils/risks?

https://www.cardiovascularbusiness.com/ ... ach-cancer
https://www.health.harvard.edu/diseases ... ach_cancer
https://www.litigationandtrial.com/prot ... ch-cancer/
https://www.ncbi.nlm.nih.gov/pubmed/29852782
"It is likely that hypergastrinemia is the pathogenic factor for gastric carcinogenesis due to PPI. PPI are the only group of drugs that causes long-term hypergastrinemia in the doses used in a clinical setting. Due to the likely carcinogenic effect, PPIs should be used carefully. Moreover, since the carcinogenic effect of Helicobacter pylori (Hp) infection also may be mediated by an increase in gastrin, Hp should be eradicated whenever treatment with PPI is initiated."

Also, I have been recently coming across articles stating that stress can also cause ulcers and gastric cancer independent of H.Pylori infection:
https://www.gastrojournal.org/article/S ... 0174-7/pdf
https://www.cghjournal.org/article/S154 ... 7/fulltext

Would this affect H.Pylori's status as being the primary cause of these diseases?

Thanks in advance!

Helico_expert
Site Admin
Posts: 4600
Joined: Wed Mar 02, 2011 7:20 am

Re: Questions on PPIs, risk, and stress

Post by Helico_expert »

Good question.

gastric cancer is indeed associated with low acid level. So perhaps long term PPI does lead to higher risk of gastric cancer. Then again, without the use of PPI, patients would suffer from reflux symptoms which ultimately can lead to throat cancer or corroded teeth.

In addition, many of those gastric cancer patients have record of HP infection previously. So it is most probably that HP planted the seed of gastric cancer, not PPI. Patients with reflux symptoms without previous HP infection has very low or no gastric cancer risk.

finally, what is the definition of long term? we have patients who take PPI for decades without problem. So, I think the important message is
1. if you have reflux symptoms, you should take PPI to prevent throat cancer.
2. It is absolutely crucial to have HP eradicated to prevent the gastric cancer seed.
3. if your reflux symptoms cannot go away after a few years of PPI, it's ok. just keep going, as long as you are free of HP.

********************************
stress can definitely induce HP like symptoms.
In Australia, HP prevalence is only 15%.
Patients with gastric symptoms who visited the GP, only 20% is HP related. 80% of those HP like symptoms are caused by something else.

In one of our double blind clinical trials where volunteers were given either live HP or placebo, one volunteers ended up in emergency in the middle of the night because of stress and anxiety. At the end of the trial, we found out that he was from the placebo group.

ankiwo72
Posts: 73
Joined: Fri May 17, 2019 2:45 am

Re: Questions on PPIs, risk, and stress

Post by ankiwo72 »

Thank you that was incredibly helpful and informative!

I am scheduled to redo the endoscopy next week for antibiotic susceptibility testing. I will only go if it is confirmed my insurance will cover the procedure so soon after the last one that was a month ago.

I will keep you posted!

Helico_expert
Site Admin
Posts: 4600
Joined: Wed Mar 02, 2011 7:20 am

Re: Questions on PPIs, risk, and stress

Post by Helico_expert »

Wish you all the best and happy new year.

ankiwo72
Posts: 73
Joined: Fri May 17, 2019 2:45 am

Re: Questions on PPIs, risk, and stress

Post by ankiwo72 »

Merry Christmas and Happy New Year to you too!

Post Reply

Return to “Hot Topics and Common forum Issues 热门话题和常见问题”