title: Role of Biopsy from Gastric Corpus in Diagnosis of Helicobacter pylori Infection in Patients on Acid Suppression Therapy.
abstract: There are reports of migration of Helicobacter pylori from the gastric antrum to the proximal stomach following acid suppression therapy. The diagnosis of H pylori infection is usually based on rapid urease test and histology of gastric antral biopsies. 50 consecutive patients of peptic ulcer, 22 on proton pump inhibitors and 28 on histamine-2 receptor antagonists for at least 4 weeks were subjected to biopsies from the gastric corpus in addition to the antrum at the time of upper gastrointestinal endoscopy. H pylori infection was detected in 42 (84%) patients. The diagnosis was established from both antral and corpus biopsies in 34 (68%) and only antrum in 4 (8%). In 4 patients, 3 on proton pump inhibitors and one on H-2 receptor antagonists, H pylori was isolated only from the corpus. The rapid urease test was positive at a mean time of 67.6 minutes from the antrum as compared to 234.6 minutes from the corpus. Testing for H pylori from the antrum alone and not the corpus would have resulted in a false negative result in 8% patients. Biopsy from the gastric antrum should always be combined with biopsy from gastric corpus for the diagnosis of H pylori infection in patients with dyspepsia on acid suppression therapy.
authors.affiliation: Classified Specialist, (Medicine and Gastroenterology), Army Hospital (R&R), Delhi Cantt - 110 010.
authors.forename: A K
authors.initials: AK
authors.lastname: Seth
authors.affiliation: Classified Specialist (Pathology), Command Hospital (Eastern Command), Kolkata - 700 027.
authors.forename: S
authors.initials: S
authors.lastname: Kakkar
authors.affiliation: Senior Advisor (Pathology), Command Hospital (Eastern Command), Kolkata - 700 027.
authors.forename: G S
authors.initials: GS
authors.lastname: Manchanda
keywords: Helicobacter pylori; Rapid urease test