Ascorbic acid and intestinal metaplasia in the stomach: a prospective, randomized study

Area of Science:

• Gastroenterology
• Oncology
• Nutritional Science

Background:

• Intestinal metaplasia is a precursor to intestinal-type gastric cancer.
• Ascorbic acid (Vitamin C) offers protection against gastric carcinogenesis by neutralizing free radicals and scavenging nitrites.

Purpose of the Study:

• To evaluate the effect of long-term ascorbic acid administration on intestinal metaplasia regression in the stomach after successful Helicobacter pylori eradication.

Main Methods:

• Sixty-five patients with gastric intestinal metaplasia post-H. pylori eradication were randomized.
• Patients received either 500 mg ascorbic acid daily for 6 months or no treatment.
• Gastric biopsies were taken before and after the 6-month intervention period for endoscopic assessment.

Main Results:

• Ascorbic acid treatment led to a significant regression of intestinal metaplasia in 31% of patients compared to 3.4% in the control group (P=0.006).
• A trend towards reduced extent of metaplasia was observed in additional patients receiving ascorbic acid.
• H. pylori recurrence occurred in 9.4% of patients and led to their exclusion.

Conclusions:

• Ascorbic acid administration significantly promotes the resolution of gastric intestinal metaplasia after H. pylori eradication.
• The findings support considering ascorbic acid as a chemoprevention agent for gastric cancer.