The October issue of Alimentary Pharmacology and Therapeutics reports an Italian study to assess whether long-term ascorbic acid administration following H. pylori eradication could affect regression of intestinal metaplasia in the stomach.
Sixty-five patients with intestinal metaplasia of the gastric mucosa after H. pylori eradication were included in the study.
An upper gastrointestinal endoscopy was performed and three biopsy specimens were taken in the antrum, three in the gastric body, and two at the incisura angularis. Patients were randomized to receive 500 mg of ascorbic acid daily after lunch (32 patients) for 6 months, or no treatment (33 patients). All patients underwent to endoscopic re-examination at the end of the 6 months.
Continuing H. pylori infection was detected in three patients from each group, who were then excluded from further analysis.
No intestinal metaplasia in 31% after ascorbic acid for 6 months.
The team was unable to find evidence of intestinal metaplasia in any biopsied site of the gastric mucosa in 9/29 (31%) patients from the ascorbic acid group, or in 1/29 (3%) of the patients from the control group (P = 0.006).
Moreover, a further six (21%) patients from the ascorbic acid group (who started with chronic inactive pangastritis with widespread intestinal metaplasia at entry) showed less extensive antritis with intestinal metaplasia at follow-up. A similar improvement was only seen in one patient from the control group (P = 0.051).
The team concludes that ascorbic acid significantly helps to resolve intestinal metaplasia of the gastric mucosa following H. pylori eradication, with a recommendation to consider its use as a chemoprevention treatment.
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