The gastric transitional zones: Neglected links between gastroduodenal pathology and Helicobacter ecology

The gastric transitional zones are the junctional zones between the differe nt types of mucosa: antral-body, body-cardia, and antrum-duodenum. In this article, the importance of the transitional zone in determining disease out come, specifically duodenal ulcer, gastric ulcer, and possibly gastric canc er, is reviewed. Both gastric ulcers and duodenal ulcers are located immedi ately adjacent to the transitional zones, The transitional zones are dynami c rather than static areas, Local acid levels determine the behavior of Hel icobacter pylori at the antral-body transitional zone and, as a consequence , the geographic distribution of gastritis in the stomach and the formation of duodenal ulcer and gastric ulcer, This review also explains that diffus e antral gastritis and multifocal atrophic gastritis are part of the same d isease and not separate entities.