SEVERITY OF HELICOBACTER-PYLORI GASTRITIS PREDICTS DUODENAL-ULCER RECURRENCE

Background: Helicobacter pylori gastritis is suggested to be the under lying condition leading to duodenal ulcer disease. The aim of the stud y was to investigate the relationship between chronic active H. pylori gastritis and the risk of duodenal ulcer (DU) recurrence. Methods. On e hundred and eighty-eight patients were followed up with regard to th e evolution of their H. pylori gastritis after they had received antib acterial or acid-suppressing treatment for their DU. Four weeks, I yea r, and 2 years after treatment and in the case of DU recurrence severa l morphologic indicators of gastritis were studied histologically in t he antrum and corpus. Results: In patients who were cured of H. pylori infection a significant and long-lasting regression of all gastritis variables were observed. Patients with persistent H. pylori infection after antibacterial treatment showed only a temporary regression of al l gastritis variables. In the overall group of patients who received a cid-suppressive therapy there was no change in gastritis. However, in the subgroup of patients who received omeprazole monotherapy, no chang e in the antrum but a statistically significant increase of gastritis in the corpus was observed. The grade of antral gastritis at the end o f treatment was significantly and positively correlated with the risk of DU recurrence and was independent of the kind of pretreatment (18.5 % recurrences in grade-2 versus 86% in grade-4 gastritis). Conclusions : The data show that the grade of gastritis is an important risk facto r for duodenal ulcer recurrence. Cure of H. pylori infection is associ ated with healing of chronic H. pylori-associated gastritis. These dat a lend considerable support to the hypothesis that H. pylori gastritis is the most important factor among those leading to duodenal ulcer di sease.