A hundred elderly dyspeptic patients were studied to assess the preval
ence of Helicobacter pylori infection and the correlation between hist
ological and serological, findings. Eighty-one per cent of the patient
s with gastritis and 63% with gastric ulcer were H. pylori positive. A
ll patients who had H. pylori negative gastritis and gastric ulcers we
re on nonsteroidal anti-inflammatory drugs (NSAIDs). There were 24 pat
ients who had evidence of H. pylori infection and were on NSAIDs. H. p
ylori positive patients had more dyspeptic symptoms in comparison with
those who were H. pylori negative. In patients who were taking NSAIDs
, the presence of severe active gastritis seemed to correlate with the
presence of H. pylori but not with the use of NSAIDs. Serology had a
sensitivity of 90% and a specificity of 93% with a negative predictive
value of 86%. There was a significant correlation between IgG titre a
nd the degree of inflammation and H. pylori infection. We conclude tha
t H. pylori gastritis is the commonest histopathological finding in el
derly dyspeptic patients. H. pylori infection may be an important risk
factor in elderly patients who take NSAIDs, increasing their risk of
gastric ulcer. H. pylori serology in elderly people has a high sensiti
vity and specificity comparable with those in young age groups.