Background/Aim: Long-term acid suppressants are known to
have adverse effects. Its effect on gastric mucosa is not known.
A cross-sectional study was undertaken to study the effect of
Helicobacter pylori on gastric mucosa among patients on longterm
Materials and methods: One hundred and twenty-six patients
with symptoms of ulcer type dyspepsia and reflux type dyspepsia
for more than a year and on acid suppressants for at least a
year were included in the study. Biopsy was obtained from the
stomach for demonstration of H. pylori and the histological
changes. The duration of treatment and presence of H. pylori
was correlated with the histological changes.
Results: Sixty-six patients were on omeprazole at a dose of
20 mg a day (group I) and the rest were on ranitidine 150 mg
twice a day (group II). Demography and the duration of treatment
was comparable in both groups. Gastric mucosa was normal in
18 (27.3%) and 30 (60%) patients in groups I and II respectively,
which was statistically significant (p = 0.01). Intestinal metaplasia
was significantly more common among those on proton pump
inhibitor (PPI) (p = 0.05). None had dysplasia or carcinoma.
The colonization of H. pylori correlated with the duration of
therapy in each of the two groups but was not statistically
significant (p > 0.05).
Conclusion: Long-term acid suppressants are generally safe.
Gastric mucosal changes especially intestinal metaplasia is
more common with PPI with fewer mucosal changes when on
H2RA and is not influenced by the presence of H. pylori.
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