Improvement of gastric inflammation and resolution of epithelial damage one year after eradication of Helicobacter pylori.
OBJECTIVE
To investigate the effect of eradication of Helicobacter pylori infection on gastric epithelial damage and gastritis, scored according to the Sydney system.


METHODS
Gastritis scores and epithelial damage were assessed in gastric biopsy specimens before, and five weeks and one year after anti-H pylori therapy in 66 patients with H pylori related gastritis.


RESULTS
The mean initial levels of activity, inflammation, atrophy, intestinal metaplasia, and H pylori scores were higher in the antrum than in the corpus or fundus. Eradication of H pylori resulted in an improvement in the mean inflammatory score in antral biopsy specimens from 2.23 before treatment to 1.32 and 1.06, respectively, five weeks and one year after treatment. Corresponding values for fundic biopsy specimens were 1.30, 0.36 and 0.35. Activity scores improved from 1.41 before treatment to 0.13 and zero, respectively, five weeks and one year after treatment in antral biopsy specimens and from 0.60 before treatment to zero in fundic biopsy specimens. Before treatment, epithelial damage was present in 51% of biopsy specimens taken from the antrum and 23% of those from the corpus. Five weeks after eradication of H pylori none of the biopsy specimens revealed evidence of epithelial damage.


CONCLUSIONS
Eradication of H pylori is followed by a rapid, significant improvement in the gastritis score and resolution of epithelial damage in antral and fundic mucosa.
Witteman
E M
EM
Department of Gastroenterology and Hepatology, Nijmegen University Hospital, The Netherlands.
Mravunac
M
M
Becx
M J
MJ
Hopman
W P
WP
Verschoor
J S
JS
Tytgat
G N
GN
de Koning
R W
RW
D001284:Atrophy / Q000473:pathology; D004848:Epithelium / Q000473:pathology; D005500:Follow-Up Studies; D005748:Gastric Fundus / Q000473:pathology; D005756:Gastritis / Q000382:microbiology* / Q000473:pathology*; D016481:Helicobacter Infections / Q000188:drug therapy / Q000473:pathology*; D016480:Helicobacter pylori / Q000302:isolation & purification*; D006801:Humans; D008679:Metaplasia / Q000473:pathology; D011706:Pyloric Antrum / Q000473:pathology