[Helicobacter pylori infection and a decrease in the pH of gastric juice as a possible cause of bleeding in erosive gastritis].
BACKGROUND
Bleeding erosive gastritis and ulcer disease are the most common causes of bleeding from the upper parts of the alimentary tract. Over the period of the last 10 years there has been an increased number of patients where Helicobacter pylori is mentioned as the possible cause of infection. At the same time in this group of patients pH values were decreased. During our research we wanted to examine the influence of local pH value and Helicobacter pylori infection on the occurrence of bleeding erosive gastritis.


METHODS
During this research we examined two groups of patients. The following parameters were examined within these two groups of patients: 1. presence of Helicobacter pylori infection; 2. histopathologic changes in mucus; 3. there were 57 patients with a bleeding form of gastritis of unknown etiology, whereas the second group consisted of 351 patients with non-bleeding form of gastritis. We examined the localization: 4. local pH.


RESULTS
The presence of Helicobacter pylori infection is statistically significantly higher in the group of patients with bleeding gastritis, when compared to the non-bleeding group (72%:57%). Within the Helicobacter positive patients the most common change of mucose (over 90%) is active chronic gastritis. The presence of erosions and histopathological changes characteristic for Helicobacter pylori infection coincides with colonization of Helicobacter in the antrum. The pathogenetic action of bacteria in antrum decreases the local pH. Therefore the lowest value of local pH occurred in the group of bleeding Helicobacter pylori positive gastritis (1.72).


CONCLUSIONS
Results of this research helped us in treatment of helicobacter pylori positive patients making a risk group for development of recurrent bleeding. We accomplished therapeutical effect in 80% of patients by using a three component eradication therapeutic protocol for helicobacter pylori. Within the group of patients who have been cured, regression of histopathological changes occurred and increase of local pH took place. In the group with persistent infection we have come across with high percentage of recurrent bleeding (37.5%).


CONCLUSIONS
In our opinion helicobaceter pylori infection and decrease of local pH, which take place during the reaction of mucose on the presence of infection, are very aggressive factors which can cause bleeding erosions.
Stevanović
D
D
Klinika za hirurgiju, Klinicko-bolnicki Centar Dr Dragisa Misović, Beograd.
Radovanović
D
D
Ivanisević
V
V
D000328:Adult; D000368:Aged; D005750:Gastric Juice / Q000737:chemistry*; D005756:Gastritis / Q000209:etiology* / Q000382:microbiology; D006471:Gastrointestinal Hemorrhage / Q000209:etiology*; D016481:Helicobacter Infections / Q000150:complications*; D016480:Helicobacter pylori; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008875:Middle Aged