title: Are clinical features able to predict Helicobacter pylori gastritis patterns? Evidence from tertiary centers.
abstract: Outcome of Helicobacter pylori infection is different according to gastritis extension (i.e. antrum-restricted gastritis or pangastritis). The aim of this study is to evaluate whether different gastritis patterns are associated with specific gastrointestinal symptoms or clinical signs that could be suggestive of the topography of gastritis. 236 consecutive symptomatic outpatients were recruited in two tertiary centers. They filled in a validated and self-administered Rome III modular symptomatic questionnaire, and underwent gastroscopy with histological sampling. 154 patients with Helicobacter pylori infection were included. Clinical presentation did not differ between antrum-restricted gastritis and pangastritis, gastro-esophageal reflux disease being present in 48.2 and 54.1 % of patients and dyspepsia in 51.8 and 45.9 %, respectively. However, pangastritis statistically differed from antrum-restricted gastritis in that the presence of clinical signs (p < 0.0001) was observed in 33.7 % of the patients, consisting of iron deficiency (31.6 %), iron deficiency-anemia (20.4 %) and levothyroxine malabsorption (3.1 %). Symptoms are not helpful in suggesting gastritis pattern whereas their association with signs, accurately detected, is indicative for the presence of pangastritis.
authors.affiliation: Department of Internal Medicine and Medical Specialties, University "Sapienza" of Rome, Viale del Policlinico 155, 00161, Rome, Italy, mcarabotti@yahoo.it.
authors.forename: Marilia
authors.initials: M
authors.lastname: Carabotti
authors.forename: Edith
authors.initials: E
authors.lastname: Lahner
authors.forename: Barbara
authors.initials: B
authors.lastname: Porowska
authors.forename: Enzo
authors.initials: E
authors.lastname: Colacci
authors.forename: Paolo
authors.initials: P
authors.lastname: Trentino
authors.forename: Bruno
authors.initials: B
authors.lastname: Annibale
authors.forename: Carola
authors.initials: C
authors.lastname: Severi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004415:Dyspepsia / Q000209:etiology; D005260:Female; D005756:Gastritis / Q000175:diagnosis* / Q000209:etiology*; D005764:Gastroesophageal Reflux / Q000209:etiology; D016481:Helicobacter Infections / Q000175:diagnosis*; D016480:Helicobacter pylori / Q000472:pathogenicity*; D006801:Humans; D008297:Male; D008875:Middle Aged