DYSFUNCTION IN GASTRIC MYOELECTRIC AND MOTOR-ACTIVITY IN HELICOBACTER-PYLORI POSITIVE GASTRITIS PATIENTS WITH NONULCER DYSPESIA

Helicobacter pylori (Hp) infection has been shown to affect gastric ac id secretion and the somatostatin-gastrin ratio but its effects on gas tric motility have not been evaluated. This study was carried out in 1 2 patients (10 males and 2 females, mean age 33+/-6 yrs) who underwent endoscopy and Campylobacter-like Organism (CLO)-test. All patients we re found initially to be Hp positive according to CLO-test. Gastric em ptying was evaluated by measuring antral diameter with ultrasonography (Hitachi EUB 240) in fasted and fed patients. Electrogastrography (EG G) with antral manometry were done 5 h before and 4 h after a meal bef ore the therapy and one month after the eradication with triple therap y (lanzoprazole 30 mg daily - 2 x 250 mg clarithromycin 500 mg t.i.d. - 3 x 500 mg and metronidazole 500 mg b.i.d. - 2 x 500 mg). In Hp posi tive patients before the triple therapy the mean fasted antral diamete r was 4.3 cm(2), initial EGG showed significant dysrhythmia of electri cal control activity (EGA) with tachygastria up to 25% of recording ti me in 9 of 12 Hp positive patients without normal increase of the powe r of signal in any of tested subjects. In 7 Hp positive fasted antral manometry failed to exhibit gastric phases III of the migrating motor complex (MMC). Hp eradication was accomplished in 10 of 12 examined pa tients and this was followed by a decrease in tachygastria to 3 cpm rh ythm with an increase of the ECA power after meal. Phase III of MMC wa s observed again in 7 Hp negative patients with a decrease of fasted a ntral diameter (p<0.05). Fasted and fed antral motility pattern increa sed after eradication. Two patients remained Hp positive after standar d therapy. We conclude that most symptomatic non ulcer dyspeptic Hp po sitive patients show changes in ECA and antral hypomotility that are a ssociated with Hp infections.