GASTRIC-ULCERS AND HELICOBACTER-HEILMANNII

Objective To compare 14 patients with gastric ulcer and Helicobacter h eilmannii with other patients with gastric ulcer: age and sex matched patients, patients colonized by Helicobacter pylori and patients on no nsteroidal antiinflammatory drugs (NSAIDs). Setting The endoscopy unit of a university-affiliated hospital. Patients and methods All patient s underwent endoscopy with two antral biopsies and smears from biopsie s (touch cytology) in addition to biopsies of ulcers. Most patients ha d fundic biopsies (n = 10), antral biopsies for culture (n = 7) and/or a urease test (n = 9). Serologic determination of antibodies against H. pylori was obtained in nine patients. Results Patients with H. heil mannii diagnosed on smears from biopsies (touch cytology) had multiple and antral ulcers in 11 samples, and nodular or irregular lesions in five samples. No patient had a history of peptic ulcer disease. Biopsy revealed mild chronic gastritis in all patients, with features of rea ctive gastritis in nine. No patient had coexistent infection with H. p ylori. Only two of ten patients with follow-up endoscopies had persist ent H. heilmannii infection on smear or biopsy. No patient had symptom atic recurrence. Patients with H. pylori infection were older and ofte n had recurrent ulceration. The majority of ulcers associated with NSA IDs occurred in elderly women. Conclusions Newly diagnosed gastric ulc ers are associated with H. heilmannii infection. Healing is associated with the disappearance of H. heilmannii and the regression of reactiv e gastritis. Ulcers differ from those associated with H. pylori infect ion or with the use of NSAIDs, suggesting that H. heilmannii is a poss ible cause of gastric ulcers. (C) 1998 Rapid Science Ltd.