Harford and colleagues describe in the October edition of Gut, 35 cases of acute gastritis with hypochlorhydria (AGH), who were first investigated in their research laboratory between 1976 and 1987.
Archived serum and gastric biopsy samples obtained from AGH subjects were examined for evidence of H. pylori colonization. Twenty eight of 33 (85%) surviving AGH subjects returned a mean of 12 years after AGH for follow-up studies, including determination of H. pylori antibodies, basal and peak acid output, endoscopy and gastric biopsies. A matched control group underwent the same studies.
Archived material provided strong evidence of new H. pylori acquisition in 14 subjects within two months, in 18 within four months, and in 22 within 12 months of recognition of AGH.
"The mechanisms by which acute H. pylori leads to transient achlorhydria are of considerable interest."
Prevalence of H. pylori colonization at follow-up was 82% (23 of 28) in AGH subjects, significantly (p < 0.05) higher than in matched controls (29%).
Basal and peak acid output returned to pre-AGH levels in all but two subjects - one of whom was found to have atrophic gastritis.
One of several possible initial manifestations of H. pylori acquisition in adults may be AGH. While H. pylori colonization usually persists, hypochlorhydria resolves in most subjects.