EFFECT OF HELICOBACTER-PYLORI ERADICATION ON GASTRIC HISTOLOGY, SERUMGASTRIN AND PEPSINOGEN-I LEVELS, AND GASTRIC-EMPTYING IN PATIENTS WITH GASTRIC-ULCER

Objective: The evolution of gastritis and the behavior of basal and me al-stimulated gastrin release, pepsinogen levels? and gastric emptying of solids mere studied in a series of consecutive patients with Helic obacter pylori-positive, uncomplicated, non-NSAID-related type I gastr ic ulcer over a follow-up period of 3 months after eradication therapy was begun. Methods: Before starting treatment (consisting of omeprazo le 40 mg a day for 1 month and amoxycillin 1 g three times daily for 1 4 days), and for 3 months after ulcer healing, 16 patients had a serie s of functional examinations, including basal and meal-stimulated seru m gastrin concentration, serum pepsinogen I levels, evaluation of gast ric emptying of solids by means of serial ultrasonographic measurement of the gastric antrum area, and histological assessment of antral and corpus gastritis. Results: Double therapy resulted in the successful eradication of H. pylori in eight of 16 evaluable patients. In the gro up of H. pylori-eradicated patients, the mean scores of gastritis acti vity and inflammation in the antrum and corpus had fallen, 3 months af ter eradication. No significant changes in mean gastritis scores were observed in the case and control group with regard to intestinal metap lasia and atrophy in the antrum and corpus. In H. pylori-eradicated pa tients, the integrated gastrin response to meal, but not fasting gastr in concentration, fell significantly during follow-up, and serum pepsi nogen I levels significantly decreased, compared with baseline. In con trast, the fasting and maximal antral area and the gastric emptying of solids remained unchanged over time. In the control group (but not th e H. pylori-eradicated group), no significant modifications of any of the above-mentioned parameters mere observed during follow-up. Conclus ion: Our findings suggest that in non-NSAID-related type I gastric ulc ers, the eradication of H. pylori significantly reduces gastritis acti vity and inflammatory scores, but not atrophy and intestinal metaplasi a, and modifies gastrin and pepsinogen I release in a short follow-up period. In contrast, H. pylori eradication does not significantly affe ct gastric emptying of solids, at least within a period of 3 months fr om therapy.