A 12-YEAR FOLLOW-UP-STUDY OF CHRONIC GASTRITIS AND HELICOBACTER-PYLORI IN A POPULATION-BASED RANDOM SAMPLE

Background: The study is a 12-year endoscopic follow-up investigation on the course of chronic gastritis and Helicobacter pylori infection i n a sample of 81 Estonian people. Methods: The series is a subset from a random sample of 227 subjects in whom a gastroduodenal endoscopy ha d been done. The grade of superficial gastritis (SG), atrophy, and col onization of the mucosa by H. pylori was evaluated in biopsy specimens from both antrum and corpus in accordance with the principles of the Sydney System. Results: The healing rate of the H. pylori and gastriti s was 0.3% (3 of 81); H. pylori colonization with gastritis developed in 5 of 81 during the follow-up. The mean prevalence of atrophic gastr itis (AG) was three times more common in the corpus than in the antrum on the average. The formation of new cases of AG and the disappearanc e of AG were quite equal during the follow-up, and the overall changes in the grade of SG and atrophy were slow. The mean life span of corpu s AG was nearly three times as long as that of antrum AG. In the antru m the grade of chronic inflammation correlated positively with the gra de of H. pylori colonization. In cases of SG a low grade of colonizati on of H. pylori in the antral mucosa in connection with moderate infla mmation predicted a reduction or even a healing of gastritis in the lo ng term. Conclusions: New H. pylori infections with subsequent gastrit is may occur in adulthood; a healing of gastritis occurs but is a quit e rare event in the course of the 12-year follow-up. Further, in the p resent random sample of Estonian people atrophic corpus gastritis did not show an overall progression, in contrast to our earlier findings.