A follow-up study of atrophic gastritis and intestinal metaplasia after eradication of Helicobacter pylori

Background. Opinions differ as to whether atrophic gastritis and intestinal metaplasia (LM) improve after Helicobacter pylori eradication. We investig ated the change of the severity of atrophy and LM after H. pylori eradicati on. Materials and Methods. Twenty H. pylori-positive pa patients with histologi cally confirmed atrophic gastritis received anti-H. pylori therapy and achi eved eradication. They were followed for 12-33 months (median 17 months) af ter the therapy. Biopsies were taken from the lesser and greater curvatures of the mid-antrum and middle body, and the incisura angularis of the stoma ch. The state of H. pylori infection was assessed histologically (Giemsa st ain). Histological severity of atrophy and IM was graded according to the U pdated Sydney System and scored on a 0-3 scale. The scores of atrophy and I M were compared between before and after the therapy (at the end of follow- up). Results. No significant difference was found in the scores of antral or bod y atrophy between before and after the therapy. Scores of antral IM increas ed after the therapy, whereas those of body LM did not change significantly . Development of IM in the whole stomach was found in three of seven patien ts who had no LM before the therapy. All of them were male smokers and drin kers. In contrast, complete regression of LM was not found. Conclusions. Our results cast doubt on the reversibility of atrophy and IM after H. pylori eradication. Development of IM could be found in some of pa tients with atrophy even after H. pylori eradication.