REVERSAL OF FUNDIC ATROPHY AFTER ERADICATION OF HELICOBACTER-PYLORI

Objectives: We sought to evaluate the effect of Helicobacter pylori er adication in patients with fundic atrophic gastritis. Methods: Acid se cretion, gastric emptying, and histology were evaluated in 20 patients with fundic atrophic gastritis and H. pylori infection. After investi gation, 10 patients (Group 1) received an eradicating treatment and 10 (Group 2) did not receive any treatment. One year later, the baseline investigations were repeated. Subsequently, patients in Group 2 recei ved the same treatment given to patients in Group I and were reevaluat ed 12 months later. A further follow-up was performed in both groups 3 6 months after the treatment. Results: At l-yr follow-up, all the pati ents in Group 1 were H. pylori negative whereas all the patients in Gr oup 2 were still infected. In Group 1, there was a significant improve ment of both fundic atrophy and acid secretion, compared with baseline (p < 0.01). In Group 2, no substantial modification of either histolo gical or functional parameters was observed at the first follow-up; co nversely, a significant (p < 0.01) improvement of fundic atrophy and a cid secretion was detected in these patients 12 months after eradicati on of the bacterium. Histological pattern remained unchanged at 36 mon ths of follow-up in both groups. Gastric emptying remained, on the ave rage, unaffected by the treatment; however, three patients with delaye d gastric emptying at entry had normal gastric emptying after eradicat ion of H. pylori. Conclusions: Our data suggest that mucosal atrophy c an be reduced or even reversed by the eradication of H. pylori, and th is is associated with a recovery of gastric function. (Am J Gastroente rol 1998;93: 1425-1431. (C) 1998 by Am. Coil. of Gastroenterology).