Helicobacter pylori-negative gastritis in erosive esophagitis, nonerosive reflux disease or functional dyspepsia patients.
BACKGROUND
Although Helicobacter pylori infection is believed to be the main cause of chronic gastritis, a US clinical trial investigating the long-term effects of lansoprazole as maintenance therapy for erosive esophagitis revealed a surprisingly high prevalence (over 90%) and severity of chronic gastritis in H. pylori-negative subjects.


OBJECTIVE
This study aims to compare prevalence and severity of chronic gastritis of the body and antrum in H. pylori-negative subjects with erosive esophagitis, nonerosive reflux disease, or functional dyspepsia from several trials.


METHODS
Pretreatment gastric histology was compared in 1595 H. pylori-negative subjects with erosive esophagitis (>or= grade 2; n=196), nonerosive reflux disease (n=688), or functional dyspepsia (n=711) who participated in US Takeda-sponsored lansoprazole trials.


RESULTS
Pretreatment histology data from US clinical studies showed that 67.5% and 75.0% of H. pylori-negative adult subjects with erosive esophagitis had moderate or severe body and antral chronic gastritis, respectively. Chronic gastritis was also observed in H. pylori-negative subjects with nonerosive reflux disease or functional dyspepsia, although prevalence was significantly less (P<0.001) than in erosive esophagitis.


CONCLUSIONS
Chronic gastritis in H. pylori-negative subjects is more common than previously appreciated. These results highlight the need for better characterization of gastric mucosal histology in these gastrointestinal disorders.
Peura
David A
DA
University of Virginia Health System, Charlottesville, VA 22908-0708 , USA. dap8v@virginia.edu
Haber
Marian M
MM
Hunt
Barbara
B
Atkinson
Stuart
S
D053799:2-Pyridinylmethylsulfinylbenzimidazoles / Q000627:therapeutic use; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000897:Anti-Ulcer Agents / Q000627:therapeutic use; D002908:Chronic Disease; D002986:Clinical Trials as Topic; D004415:Dyspepsia / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology*; D004941:Esophagitis / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology*; D005260:Female; D005753:Gastric Mucosa / Q000473:pathology; D005756:Gastritis / Q000453:epidemiology / Q000209:etiology*; D005764:Gastroesophageal Reflux / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology*; D006801:Humans; D064747:Lansoprazole; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D012720:Severity of Illness Index; D055815:Young Adult
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000897:Anti-Ulcer Agents; D064747:Lansoprazole