Antralization at the edge of proximal gastric ulcers: does Helicobacter pylori infection play a role?
OBJECTIVE
To determine the prevalence of antralization at the edge of proximal gastric ulcers, and the effect of H. pylori eradication on the mucosal appearances.


METHODS
Biopsies were taken from the antrum, body and the ulcer edge of patients with benign proximal gastric ulcers before and one year after treatment. Gastric mucosa was classified as antral, transitional or body type. H. pylori positive patients received either triple therapy, or omeprazole.


RESULTS
Patients with index ulcers in the incisura, body or fundus (n=116) were analyzed. Antral-type mucosa was more prevalent at the ulcer edge in H. pylori-positive patients than H. pylori-negative patients (93 % vs 60 %, OR=8.95, 95 %CI: 2.47-32.4, P=0.001). At one year, there was a significant reduction in the prevalence of antralization (from 93 % to 61 %, P=0.004) at the ulcer edge in patients with H. pylori being eradicated. However, there was no difference in the prevalence of antralization at the ulcer edge in those with persistent infection.


CONCLUSIONS
H. pylori infection is associated with antralization at the edge of proximal gastric ulcers, which may be reversible in some patients after eradication of the infection.
Xia
Harry Hua-Xinag
HH
Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong, China.
Lam
Shiu Kum
SK
Wong
Wai Man
WM
Hu
Wayne Hsing-Cheng
WH
Lai
Kam Chuen
KC
Wong
Sau Hing
SH
Leung
Suet Yi
SY
Yuen
Siu Tsan
ST
Wright
Nicholas A
NA
Wong
Benjamin Chun-Yu
BC
D000368:Aged; D000900:Anti-Bacterial Agents; D000897:Anti-Ulcer Agents / Q000627:therapeutic use; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D005260:Female; D005753:Gastric Mucosa / Q000473:pathology; D016481:Helicobacter Infections / Q000150:complications* / Q000188:drug therapy; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008875:Middle Aged; D009853:Omeprazole / Q000627:therapeutic use; D011706:Pyloric Antrum / Q000473:pathology*; D013276:Stomach Ulcer / Q000188:drug therapy / Q000382:microbiology* / Q000473:pathology*
D000900:Anti-Bacterial Agents; D000897:Anti-Ulcer Agents; D009853:Omeprazole