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Review
. 2012 Oct;57(10):2504-15.
doi: 10.1007/s10620-012-2203-7. Epub 2012 Apr 28.

Vitamin C, gastritis, and gastric disease: a historical review and update

Anupam Aditi  1 , David Y Graham
Affiliations
Review

Vitamin C, gastritis, and gastric disease: a historical review and update

Anupam Aditi et al. Dig Dis Sci. 2012 Oct.

Abstract

The discovery of Helicobacter pylori as the cause of gastritis and peptic ulcers ushered in the modern era of research into gastritis and into acid-peptic diseases and rekindled interest in the role of ascorbic acid in the pathophysiology and treatment of gastritis and peptic ulcer disease. Here, we review historic and modern studies on ascorbic acid and gastric diseases with an emphasis on H. pylori gastritis and its sequelae. The relationship of ascorbic acid and gastritis and peptic ulcer and its complications was extensively studied during the 1930s through the 1950s. Much of this extensive literature has been effectively "lost." Ascorbic acid deficiency was associated with all forms of gastritis (e.g., autoimmune, chemical, and infectious) due in varying degrees to insufficient intake, increased metabolic requirements, and destruction within the GI tract. Importantly, gastritis-associated abnormalities in gastric ascorbic acid metabolism are reversed by H. pylori-eradication and potentially worsened by proton pump inhibitor therapy. Diets rich in naturally occurring ascorbic acid are associated with protection of the gastric corpus from atrophy and a reduction in the incidence of gastric cancer possibly through the ability of ascorbic acid to reduce oxidative damage to the gastric mucosa by scavenging carcinogenic N-nitroso compounds and free radicals and attenuating the H. pylori-induced inflammatory cascade. Ascorbic acid supplementation was possibly associated with a decreased incidence of bleeding from peptic ulcer disease. Pharmacologic doses of ascorbic acid also may improve the effectiveness of H. pylori-eradication therapy. Occasionally, looking back can help plot the way forward.

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Figures

Figure 1
Figure 1
Urinary ascorbic acid excretion in 6 subjects with gastric ulcers compared to minimal normal excretion of 13 mg/day Adapted from [17]
Figure 2
Figure 2
Plasma and Gastric ascorbic acid levels in controls versus subjects with gastric pathology Adapted from (23]
See this image and copyright information in PMC

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