LONG-TERM FOLLOW-UP OF GASTRIC HISTOLOGY AFTER HELICOBACTER-PYLORI ERADICATION

Helicobacter pylori causes chronic active gastritis and is thought to be associated with the development of gastric atrophy, intestinal meta plasia and carcinoma. As the effect of H. pylori eradication on this p rocess is poorly understood, we sought to determine the long-term effe cts of H. pylori eradication on gastric histology. Fifty-four patients with duodenal ulceration associated with H. pylori infection received H. pylori eradication therapy in 1985/86 and either remained infected (n = 22) or had the infection eradicated (n = 32); patients were foll owed up by endoscopy with gastric antral biopsy for 7.1 years (mean). Histopathological analysis of gastric antral mucosa from patients rend ered H. pylori negative revealed a marked decrease in both inflammator y cells within the lamina propria and intraepithelial neutrophils and an increase in epithelial mucinogenesis. Gland atrophy remained unchan ged in both H. pylori-positive and -negative patients. When examined f or the presence and severity of intestinal metaplasia, there was neith er a difference between the two patient groups nor a change with time. These data demonstrate that significant long-term improvements in gas tric histology accompany H. pylori eradication when compared with hist ology in patients with persistent infection. Whether this confers a pr otective effect by reducing the risk of gastric carcinoma remains unkn own.