GASTRIC-ULCER AND HELICOBACTER-PYLORI - C LINICAL, ENDOSCOPIC AND HISTOLOGIC CHARACTERISTICS

Objectives. - The aim of the study was to determine in a large group o f patients with a gastric ulcer the differences between patients, ulce rs and gastric mucosa as related to the presence or absence of Helicob acter pylori (H. pylori). Methods. - This prospective study evaluated 150 patients with a benign gastric ulcer. A patient was considered as H. pylori positive on the basis of a positive culture or the presence of gastritis and another positive diagnostic test for H. pylori (ureas e test, cytology, histology, serology). Results. - One hundred and fiv e patients were positive for H. pylori (70%) whereas 45 patients were not infected (30%). There were significant differences' regarding the clinical characteristics of patients, the ulcer and the mucosa. H. pyl ori positive patients differed in terms of past history of ulcer (63 v s 12%), age (57 vs 50 years) sex (48% males vs 24%) and consumption of nan steroidal antiinflammatory drugs (39 vs 75%). H. pylori positive ulcers were more often single (79 vs 53%) and located on the small cur vature (76 vs 33%). Chronic gastritis was always present in positive p atients, with associated intestinal metaplasia (35 vs 2%) and atrophy (45 vs 9%). Negative patients often had a normal gastric mucosa (53%) or reactive gastritis (27%). Conclusion. - Seventy percent of gastric ulcer are associated with H. pylori infection, corresponding to the cl assical ulcer The majority of H. pylori negative ulcers appears to be associated to non steroidal antiinflammatory drugs.