Premium
Hypochlorhydria induced by a proton pump inhibitor leads to intragastric microbial production of acetaldehyde from ethanol
Author(s) -
Väkeväinen S.,
Tillonen J.,
Salaspuro M.,
JousimiesSomer H.,
Nuutinen H.,
Färkkilä M.
Publication year - 2000
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1046/j.1365-2036.2000.00858.x
Subject(s) - acetaldehyde , lansoprazole , ethanol , proton pump inhibitor , chemistry , ingestion , stomach , pharmacology , food science , medicine , helicobacter pylori , biochemistry
Background: Acetaldehyde, produced locally in the digestive tract, has recently been shown to be carcinogenic in humans. Aim: To examine the effect of iatrogenic hypochlorhydria on intragastric acetaldehyde production from ethanol after a moderate dose of alcohol, and to relate the findings to the changes in gastric flora. Methods: Eight male volunteers ingested ethanol 0.6 g/kg b.w. The pH, acetaldehyde level and microbial counts of the gastric juice were then determined. The experiment was repeated after 7 days of lansoprazole 30 mg b.d. Results: The mean (± S.E.M.) pH of the gastric juice was 1.3 ± 0.06 and 6.1 ± 0.5 ( P < 0.001) before and after lansoprazole, respectively. This was associated with a marked overgrowth of gastric aerobic and anaerobic bacteria ( P < 0.001), by a 2.5‐fold ( P =0.003) increase in gastric juice acetaldehyde level after ethanol ingestion, and with a positive correlation ( r =0.90, P < 0.001) between gastric juice acetaldehyde concentration and the count of aerobic bacteria. Conclusions: Treatment with proton pump inhibitors leads to hypochlorhydria, which associates with intragastric overgrowth of aerobic bacteria and microbially‐mediated acetaldehyde production from ethanol. Since acetaldehyde is a local carcinogen in the concentrations found in this study, long‐term use of gastric acid secretory inhibitors is a potential risk‐factor for gastric and cardiac cancers.