Helicobacter pylori and non-steroidal anti-inflammatory drugs: uncomfortable partners in peptic ulcer disease.

Helicobacter pylori and non-steroidal anti-inflammatory drugs: uncomfortable partners in peptic ulcer disease Recent studies have suggested that Helicobacter pylon and non-steroidal anti-inflammatory drugs (NSAIDs) are capable of interfering with various protective mechanisms in the gastroduodenal mucosa. Whereas NSAIDs are recognised for their acid stimulating activity, the effect of H pylori on gastric acid secretion remains highly speculative despite its association with hypergastrinaemia. Both H pylon and NSAIDs have, however, been shown to influence the production rate and the quality of gastric cyclic AMP, the mucus layer, mucosal prostaglandins, blood flow, and platelet activating factor. Characteristic histological abnormalities have also been identified. Also NSAID related peptic ulcers seem to develop more commonly in patients infected with H pylori despite the apparent reduction in the prevalence of these organisms in chronic NSAID users, hence the uncomfortable relation between the two aetiological factors. It remains to be seen whether the eradication of H pylori would reduce the frequency of peptic ulcers induced by NSAIDs or prevent their recurrence.