HISTOLOGY OF CHRONIC GASTRITIS WITH AND WITHOUT DUODENITIS IN PATIENTS WITH HELICOBACTER-PYLORI INFECTION

Aim-To compare the histological characteristics of Helicobacter pylori positive chronic gastritis in patients with and without associated du odenitis. Methods-Gastric mucosal biopsy specimens were obtained from patients undergoing endoscopy for dyspepsia. Severity of gastritis and density of H pylori infection were graded according to the Sydney sys tem. Results-Of the 69 patients studied, 15 had normal histology, 22 h ad chronic gastritis only (77.3% H pylori positive), 21 had duodenitis (90.5% H pylori positive), and 11 had other diagnoses. In the H pylor i positive patients, the median gastritis score was higher in the duod enitis group (6, range 3-9) than in the chronic gastritis only group ( 5, range 2-8), because of greater neutrophil activity scores in patien ts with duodenitis (median score 2 v 1). There were no differences in the density of H pylori infection, inflammation, atrophy, or intestina l metaplasia between patients with chronic gastritis only and those wi th duodenitis. Conclusions-These results suggest that H pylori positiv e patients with duodenitis have a more severe form of gastritis than t hose without associated duodenal inflammation. This is because of incr eased neutrophil activity, which seems to be independent of the densit y of H pylori infection.