title: Analyzing the influence of gastric intestinal metaplasia on gastric ulcer healing in Helicobacter pylori-infected patients without atrophic gastritis.
abstract: BACKGROUND
  Gastric epithelial hyper-proliferation was reported in patients with Helicobacter pylori (H. pylori)-infected gastric mucosa with intestinal metaplasia (IM) changes. In patients with gastric ulcer (GU) and IM, the GU may have a different healing rate in comparison to patients without IM. This study aimed to compare the difference in GU healing between H. pylori-infected patients with IM and those without IM.
  
  
  METHODS
  We retrospectively analyzed patients at the Keelung Chung Gung Memorial Hospital during the period from March 2005 to January 2011. The inclusion criteria were: 1) endoscopic findings of GU and biopsy histological examination plus rapid urease test indicating H. pylori infection; 2) gastric IM adjacent to a GU but with no atrophic gastritis changes; 3) patients receiving H. pylori eradication triple therapy and 8 weeks of maintenance therapy with a proton pump inhibitor; and 4) patients receiving follow-up endoscopy within the 3rdand the 4thmonths after treatment.
  
  
  RESULTS
  In total, 327 patients with GU and H. pylori infection (136 with IM and 191 without IM) were included. Patients with IM had a higher GU healing rate than those without IM (91.9% vs. 84.3%, P = 0.040). Multivariate logistical regression analysis revealed that failure of H. pylori eradication (Odds = 4.013, 95% CI: 1.840-8.951, P < 0.001) and gastric IM (Odds = 0.369, 95% CI: 0.168-0.812, P = 0.013) were the predictors of non-healing GU following treatment.
  
  
  CONCLUSIONS
  Patient with gastric IM change may have a higher GU healing rate than those without gastric IM. However, successful H. pylori eradication is a more important factor for GU healing than gastric IM.
authors.affiliation: Departments of Gastroenterology and Hepatology, Chang-Gung Memorial Hospital and University, 12F, No 222, Mai-Jin Road, Keelung, Taiwan.
authors.forename: Li-Wei
authors.initials: LW
authors.lastname: Chen
authors.affiliation: Departments of Pathology, Chang-Gung Memorial Hospital and University, 12F, No 222, Mai-Jin Road, Keelung, Taiwan.
authors.forename: Liang-Che
authors.initials: LC
authors.lastname: Chang
authors.affiliation: Departments of Internal Medicine, Chang-Gung Memorial Hospital and University, 12F, No 222, Mai-Jin Road, Keelung, Taiwan.
authors.forename: Chung-Ching
authors.initials: CC
authors.lastname: Hua
authors.affiliation: Departments of Gastroenterology and Hepatology, Chang-Gung Memorial Hospital and University, 12F, No 222, Mai-Jin Road, Keelung, Taiwan.
authors.forename: Bor-Jen
authors.initials: BJ
authors.lastname: Hsieh
authors.affiliation: Departments of Gastroenterology and Hepatology, Chang-Gung Memorial Hospital and University, 12F, No 222, Mai-Jin Road, Keelung, Taiwan.
authors.forename: Shuo-Wei
authors.initials: SW
authors.lastname: Chen
authors.affiliation: Departments of Gastroenterology and Hepatology, Chang-Gung Memorial Hospital and University, 12F, No 222, Mai-Jin Road, Keelung, Taiwan. ronald@cgmh.org.tw.
authors.forename: Rong-Nan
authors.initials: RN
authors.lastname: Chien
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D005260:Female; D016481:Helicobacter Infections / Q000150:complications* / Q000188:drug therapy / Q000382:microbiology; D016480:Helicobacter pylori; D006801:Humans; D007422:Intestines / Q000382:microbiology / Q000473:pathology*; D016015:Logistic Models; D008297:Male; D008679:Metaplasia / Q000150:complications / Q000382:microbiology; D008875:Middle Aged; D015999:Multivariate Analysis; D054328:Proton Pump Inhibitors / Q000627:therapeutic use; D012189:Retrospective Studies; D013270:Stomach / Q000382:microbiology / Q000473:pathology*; D013276:Stomach Ulcer / Q000150:complications / Q000382:microbiology / Q000473:pathology*
chemical_list: D000900:Anti-Bacterial Agents; D054328:Proton Pump Inhibitors
keywords: Helicobacter pylori; Intestinal metaplasia; Peptic ulcer