Antacids and Hz-receptor antagonists are effective in the treatment of peptic ulcers. Reduction of acid secretion Ied to a rise in concentrations of intragastric aerobic bacteria and nitrate reducing bacteria. Nitrate reducing bacteria are able to convert endoand exogenous nitrates to nitrites, leading potentially to the synthesis of ´N-nitrosamines. These compounds are carcinogenic in experimental animals and could contribute to the development of malignancy.
The present study was undertaken to see whether acid secretion by treatment with antacids and ´Hz-receptor antagonists can induce formation of intraluminal nitrites, and withdrawal of antacids and Hz receptor antagonists can restore intraluminal nitrites.
24 normal subjects and 43 patients with endoscopically proven peptic ulcers were admitted to the study. Gastric juice of peptic ulcer patients were collected before, during, and after treatment with antacids and H2-receptor antagonists and that of normal subjects were collected only I time. Gastric juice was obtained with endoscopic aspiration. The pH and nitrite concentration were measured and compared.
The result are as follow:
1. In gastric ulcer and duodenal ulcer, treatment with antacids and H2 receptor antagonist significantly increased gastric pH and nitrite concentration and withdrawal of antacids and HZ-receptor antagonist resulted in a significant reduction of pH and nitrite concentration. There was no statistical difference in pH and nitrite concentration between the group who were not treated and the group who were off the, drug from 3 to 16 months before sampling.
2. Correlation between pH and nitrite concentration were present in gastric ulcer and duodenal, ulcer before treatment with antacids and HZ-receptor antagonist (Gastric ulcer: r=0.8600, p<0.001, Duodenal ulcer: r=0.8157, p<0.001).
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