Influence of proton pump inhibitors on gastritis diagnosis and pathologic gastric changes

Table 1 Baseline patient characteristics n (%)

Characteristics	Value
Age, median (range), yr	50 (20-87)
Gender
Male	150 (50)
Female	150 (50)
Symptoms
Abdominal burn	152 (50.70)
Heart burn	37 (12.30)
Dyspepsia	33 (11)
Past medical history
Hypertension	81 (27)
Dyslipidemia	53 (17.7)
Diabetes mellitus	36 (12)
Hypothyroidism	9 (3)
Social habits
Smoking	126 (42)
Exercise	98 (32.7)
Alcohol intake	62 (20.7)
Medication history
Anti hypertensives	86 (28.7)
Anti dyslipidemics	54 (18)
Oral hypoglycemics	28 (9.3)
Sedatives	15 (5)
Anti-depressants	16 (5.3)
PPIs1	155 (51.7)
Indications for PPI use
Gastritis	21 (13.5)
GERD	48 (31)
GI ulcer	10 (6.5)
Undocumented diagnosis	76 (49)

¹Proton pump inhibitors used: Rabeprazole (47%), esomeprazole (33%), omeprazole (17%), others (3%). GERD: Gastroesophageal reflux disease; PPIs: Proton pump inhibitors; GI: Gastrointestinal.

Table 2 Effect of proton pump inhibitors exposure on Helicobacter pylori detection, density and intestinal metaplasia n (%)

	Previous PPI exposuren = 155	No PPI exposuren = 145	P value
H. pylori gastritis	53 (34.20)	103 (71)	< 0.001
Inactive chronic gastritis	102 (65.80)	42 (29)	< 0.001
H. pylori density
Low density	40 (25.80)	52 (35.90)	< 0.001
High density	13 (8.38)	51 (35.17)	< 0.001
Intestinal metaplasia	10 (6.50)	2 (1.40)	0.023

PPI: Proton pump inhibitor; H. pylori: Helicobacter pylori.

Table 3 Effect of proton pump inhibitors exposure on Helicobacter pylori detection, density and intestinal metaplasia following gastroesophageal reflux disease patients exclusion n (%)

	Previous PPI exposuren = 109	No PPI exposuren =143	P value
Gastritis
H. pylori gastritis	44 (40.40)	101 (70.60)
Inactive chronic gastritis	65 (59.60)	42 (29.40)	< 0.0001
H. pylori density
Low density	33 (75.0)	52 (51.50)
High density	11 (25.0)	49 (48.50)	0.010
Intestinal metaplasia	7 (6.40)	2 (1.40)	0.042

PPI: Proton pump inhibitor; H. pylori: Helicobacter pylori.

Table 4 Univariate analysis to determine the association between age, gender, exercise, smoking, alcohol intake, gastroesophageal reflux disease and previous proton pump inhibitors exposure with the detection of Helicobacter pylori

	OR	95%CI	P value
Age	1.019	1.002-1.036	0.028
Gender	1.256	0.76-2.07	0.373
Exercise	0.664	0.389-1.136	0.135
Smoking	0.789	0.476-1.308	0.358
Alcohol intake	0.505	0.27-0.944	0.032
GERD	0.165	0.077-0.355	< 0.01
Previous PPI exposure	0.281	0.166-0.476	< 0.01

GERD: Gastroesophageal reflux disease; PPI: Proton pump inhibitor.

Table 5 Multivariate analysis to evaluate the effect of age, exercise, alcohol intake, gastroesophageal reflux disease and previous proton pump inhibitors exposure on the detection of Helicobacter pylori

	OR	95%CI	P value
Age	1.022	1.004-1.041	0.017
Alcohol intake	0.396	0.195-0.804	0.010
Exercise	0.721	0.393-1.321	0.289
GERD	0.317	0.132-0.763	0.010
Previous PPI exposure	0.217	0.123-0.385	< 0.01

GERD: Gastroesophageal reflux disease; PPI: Proton pump inhibitor.