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Low-nickel diet helps eradicate Helicobacter.

Fifty-two patients (mean age, 42 years) with newly diagnosed Helicobacter pylori infection were randomly assigned to consume a standard diet or a low-nickel diet for 30 days. On the low-nickel diet, all foods high in nickel content were prohibited. Starting on day 15 of the diet, all patients were treated with 15 mg of lansoprazole, 500 mg of clarithromycin, and 1000 mg of amoxicillin, each twice a day for 7 days. H. pylori eradication was assessed by the urea breath test 4 weeks after the end of the treatment period. The H. pylori eradication rate was significantly higher among patients on the low-nickel diet than among patients on the standard diet (84.6% vs. 46.2%; p < 0.01). The incidence of treatment-related side effects did not differ between groups.

Comment: H. pylori contains a nickel-dependent urease enzyme. This enzyme catalyzes the hydrolysis of urea in gastric juice to form ammonia, an alkaline compound that protects the organism against gastric acidity. NiFe-hydrogenase is another nickel-dependent enzyme produced by H. pylori that helps the organism survive the acid environment of the stomach. The results of the present study demonstrate that the addition of a low-nickel diet to standard triple therapy significantly increased the H. pylori eradication rate. The decrease in H. pylori urease activity due to the low-nickel diet could expose the bacterium to gastric acid and increase its susceptibility to amoxicillin.

Campanale M et al. Nickel free-diet enhances the Helicobacter pylori eradication rate: a pilot study. Dig Dis Sci. 2014;59:1851-1855.

by Alan R. Gaby, MD

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Title Annotation:Literature Review & Commentary
Author:Gaby, Alan R.
Publication:Townsend Letter
Article Type:Brief article
Date:Jul 1, 2015
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