HIGH-FREQUENCY OF HELICOBACTER NEGATIVE GASTRITIS IN PATIENTS WITH CROHNS-DISEASE

The frequency of gastric Crohn's disease has been considered low. This study was undertaken to determine the prevalence of chronic gastritis and Helicobacter pylori infection in patients with Crohn's disease. O esophagogastroduodenoscopy was performed on 62 consecutive patients su ffering from ileocolonic Crohn's disease. Biopsy specimens from the an trum and corpus were processed for both histological and bacteriologic al examinations. H pylori antibodies of IgG and IgA classes were measu red in serum samples by enzyme immunoassay. Six patients (9.7%) were i nfected with H pylori, as shown by histology, and in five of them the infection was also verified by serology. Twenty one (32%) had chronic H pylori gastritis (negative by both histology and serology) and one o f them also had atrophy in the antrum and corpus. Granulomas were foun d in four patients. The characteristic appearance of H pylori negative gastritis was focal and mostly mild inflammation resembling the infla mmatory changes seen in the gut in Crohn's disease. Patients with H py lori negative chronic gastritis had a significantly more active diseas e in their gut than those with normal gastric mucosa (p<0.01). It is c oncluded that H pylori positive gastritis is rare, while H pylori nega tive gastritis is relatively common in patients with Crohn's disease. H pylori negative 'Crohn's gastritis' seems to be associated with acti ve Crohn's disease.