engleski

Improvement in gastric histology following Helicobacter pylori eradication

Although curative treatment of H.pylori infection markedly reduces relapse of peptic ulcers, concomitant improvement of histological signs of chronic gastritis activity is less clear and has to be measured. We aimed to determine if successful or failed eradication of Helicobacter pylori causes any difference in gastric mucosal histology during follow up of two or more years. We compared 186 successfully eradicated patients (96F/90M ; age 54.5, range 21-79) with peptic ulcer(83%) or chronic gastritis(17%), followed for at least 2 years (range, 2-8 years) (Group A), with another 63 age- and disease-matched H. pylori-positive controls (33F/30M ; age 56, 7, range 24-81, peptic ulcer(81%), chronic gastritis(19%), without successful eradication after many attempts, only on symptomatic therapy (Group B). Endoscopy with histology was performed on every control (2 biopsies from antrum and 2 from corpus). Morphological variables of gastritis were graded according to the updated Sydney System (degree of: inflammation-IN, neutrophil activity-NA, atrophy-AT and intestinal metaplasia-IM) During follow up period IN- and NA-score, both in corpus and antrum, decreased significantly and continuously in Group A. AT-score showed same tendency, as well as IM-score in corpus bat not so fast. IM-score in antrum remained unchanged as well as all scores in Group B, without expected progression in AT- and IM-score. Chronic gastritis activity gradually improved with successful eradication of H. pylori infection. There were no significant progresion in gastric mucosal atrophy among noneradicated patients despite of frequent PPI therapy use.

Helicobacter pylori; Histology; Eradication

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