Hypochlorhydria induced by a proton pump inhibitor leads to intragastric microbial production of acetaldehyde from ethanol.

Abstract

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.

• Authors: S Väkeväinen, J Tillonen, M Salaspuro, H Jousimies-Somer, H Nuutinen, M Färkkilä
• Journal: Alimentary pharmacology & therapeutics (Aliment Pharmacol Ther) Vol. 14 Issue 11 Pg. 1511-8 (Nov 2000) ISSN: 0269-2813 [Print] England
• PMID: 11069323 (Publication Type: Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• 2-Pyridinylmethylsulfinylbenzimidazoles
• Anti-Ulcer Agents
• Proton Pump Inhibitors
• Lansoprazole
• Ethanol
• Acetaldehyde
• Omeprazole

Topics

• 2-Pyridinylmethylsulfinylbenzimidazoles
• Acetaldehyde (metabolism)
• Achlorhydria (chemically induced)
• Adult
• Anti-Ulcer Agents (adverse effects)
• Bacteria (growth & development)
• Ethanol (metabolism)
• Gastric Juice (metabolism)
• Gastric Mucosa (drug effects, metabolism, microbiology)
• Humans
• Hydrogen-Ion Concentration
• Lansoprazole
• Male
• Omeprazole (adverse effects, analogs & derivatives)
• Proton Pump Inhibitors