Elimination of Helicobacter pylori under treatment with omeprazole

Biopsies from the stomachs (antrum and corpus) of 201 patients with peptic ulcers or reflux oesophagitis were retrospectively investigated for the effect of treatment with omeprazole on the elimination of Helicobacter pylori (HP) and on gastritis. Of 64 patients without gastritis two (3.1%) developed gastritis during treatment. Among 134 patients with HP gastritis undergoing treatment, 48 (35.8%) experienced no HP elimination, in 41 (30.6%) there was HP elimination from the antrum, but HP persistence in the corpus, while in 45 (33.6%) HP was eliminated from both antrum and corpus. HP elimination led to a reduction in the degree and activity of gastritis under omeprazole treatment. Only eight patients were examined after completion of treatment, and in three in whom HP had been eliminated, recolonization was found to have occurred. The disappearance of HP in Type A gastritis coupled with the fact that HP is highly sensitive to contamination with other bacteria--as observed in the laboratory--suggests that this now partially established elimination of HP under the strongly acid-inhibiting omeprazole therapy can be traced back to a bacterial overgrowth of the gastric mucosa.