Nickel free-diet enhances the Helicobacter pylori eradication rate: a pilot
study.
Author(s): Campanale M(1), Nucera E, Ojetti V, Cesario V, Di Rienzo TA, D'Angelo G, Pecere
S, Barbaro F, Gigante G, De Pasquale T, Rizzi A, Cammarota G, Schiavino D,
Franceschi F, Gasbarrini A.
Affiliation(s): Author information:
(1)Internal Medicine and Endoscopy, Gemelli Hospital, Largo A. Gemelli, 8, 00168,
Rome, Italy, chiaracampanale@hotmail.com.
Publication date & source: 2014, Dig Dis Sci. , 59(8):1851-5
BACKGROUND: The Helicobacter pylori eradication rate with standard triple therapy
is very low. H. pylori is known to require the nickel-containing metalloenzymes
urease and NiFe-hydrogenase to survive at the low pH environment in the stomach.
AIM: To compare the H. pylori eradication rate of a nickel free-diet associated
with standard triple therapy and standard triple therapy alone as the first-line
regimen.
METHODS: Fifty-two sex- and age-matched patients at the first diagnosis of H.
pylori infection were randomized 1:1 into two different therapeutic schemes: (1)
standard LCA (26 patients): lansoprazole 15 mg bid, clarithromycin 500 mg bid and
amoxicillin 1,000 mg bid for 7 days with a common diet; (2) standard LCA plus a
nickel free-diet (NFD-LCA) (26 patients). Patients followed 30 days of a
nickel-free diet plus a week of lansoprazole 15 mg bid, clarithromycin 500 mg bid
and amoxicillin 1,000 mg bid starting from day 15 of the diet.
RESULTS: All patients completed the study. A significantly higher eradication
rate was observed in the NFD-LCA group (22/26) versus LCA group (12/26) (p <
0.01). Only a few patients (9 of 52) reported the occurrence of mild
therapy-related side effects, without any significant differences between the two
groups.
CONCLUSIONS: The addition of a nickel-free diet to standard triple therapy
significantly increases the H. pylori eradication rate. The reduction of H.
pylori urease activity due to the nickel-free diet could expose the bacterium to
gastric acid and increase H. pylori's susceptibility to amoxicillin. Further
studies are necessary to confirm this preliminary result.
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