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Multiple and diverse consequences of inhibiting gastric acid secretion: remembering the bicentenary of William Prout’s discovery
  1. D Mark Pritchard1,
  2. Robert Logan2
  1. 1Department of Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, UK
  2. 2Department of Gastroenterology, Kings College Hospital, London, UK
  1. Correspondence to Professor D Mark Pritchard, Department of Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, L69 3BX, UK; dmpritch{at}

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We have read with interest several recent papers in Gut that have reported novel insights about the potential consequences of reduced gastric acid secretion. These include reports that proton pump inhibitor (PPI) use increases the risks of developing diverse diseases including gastric adenocarcinoma1 2 and severe COVID-19 infection.3 An intriguing recent paper has also shown that pathological suppression of gastric acid secretion in people with autoimmune atrophic gastritis does not predispose to gastric adenocarcinoma development unless they are also infected with Helicobacter pylori.4 These patients are, however, more prone to developing type 1 gastric neuroendocrine (carcinoid) tumours (NETs). Interestingly, gastric NETs do not develop in people who have H. pylori induced atrophic gastritis or following long term drug-induced acid inhibition.

These observations highlight the complexity of the regulation of gastric acid secretion …

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  • Contributors DMP and RL conceived the article in their roles as secretary and treasurer of the Prout club. DMP wrote the first draft and RL edited this document for important intellectual content. Both authors approved the final version of the letter.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.