EFFECTS OF PERMANENT ERADICATION OR TRANSIENT CLEARANCE OF HELICOBACTER-PYLORI ON HISTOLOGY OF GASTRIC-MUCOSA USING OMEPRAZOLE WITH OR WITHOUT ANTIBIOTICS

Changes in Helicobacter pylori-associated gastritis of the antrum and corpus were investigated in a large number of patients treated with om eprazole, with or without the addition of amoxycillin. To investigate the role of H. pylori-associated gastritis in ulcerogenesis and its in terplay with omeprazole, biopsies were taken and evaluated according t o the Sydney system. Successful eradication of H. pylori (assessed his tologically 4 weeks after the end of therapy) led to prompt and persis tent suppression of gastritis activity, slow, partial regression of mo nonuclear inflammation and an ulcer recurrence rate of only 14% during the 6 months' follow-up. In patients treated with omeprazole and plac ebo, or where eradication treatment with omeprazole and amoxycillin ha d failed, transient clearance of H. pylori from the antral (but not ox yntic) mucosa was seen. In both of these groups of patients transient regression in the antrum, and worsening in the corpus, of gastritis ac tivity and mononuclear inflammation were evident, coupled with ulcer r ecurrence rates of 72 and 46%, respectively. It was concluded that H. pylori colonization and gastritis activity play a crucial role in ulce rogenesis, that acid inhibition treatment improves antral H. pylori ga stritis and worsens the oxyntic mucosal gastritis, and that this can b e prevented by eradication of the H. pylori infection.