The role of Helicobacter pylori in non-ulcer dyspepsia and gastritis.
A review is presented on the relationship between Helicobacter pylori infection and gastritis and its possible significance in non-ulcer dyspepsia. Although there is consensus about the pathogenetic role of H. pylori in gastritis, the correlation between H. pylori and gastritis does not appear to be qualitative, as generally thought and accepted, but rather quantitative. It is not a black and white relationship; in other words the microorganism is present in large quantities in inflamed tissue but is also present in normal healthy mucosa in low numbers. The hypothesis is proposed of an equilibrium between virulence of H. pylori on the one hand and mucosal defence mechanism on the other hand. Distortion could lead to an attack of gastritis. The present view is that the bacterium is neither commensal nor pathogen, but is able to change its role depending on the local and momentary situation. Given the presence of H. pylori infection in patients with non-ulcer dyspepsia, with or without gastritis, the significance of the infection is probably greater than thought.
Loffeld
R J
RJ
Department of Internal Medicine and Pathology, University Hospital Maastricht, Netherlands.
Arends
J W
JW
D004415:Dyspepsia / Q000382:microbiology*; D005756:Gastritis / Q000382:microbiology*; D016481:Helicobacter Infections / Q000150:complications*; D016480:Helicobacter pylori; D006801:Humans