Two- to four-year histological follow-up of gastric mucosa after Helicobacter pylori eradication

In a 2- to 4-year prospective study, the reversibility of gastritis after H elicobacter pylori eradication was analysed, Sixty-three H. pylori-positive , chronic duodenal ulcer patients were studied after the successful eradica tion of bacteria in the period from 1990 to 1993, H. pylori eradication was obtained by triple antimicrobial regimens (colloidal bismuth subcitrate, a moxicillin, and metronidazole) applied for at least 14 days. The criteria f or eradication were the absence of bacteria from two antral and ho body of stomach biopsies stained with haematoxylin, eosin, and Warthin Starry, and a negative antral biopsy culture. The same diagnostic procedures were repea ted, at regular follow-up endoscopies, each ear for up to 4 years. Neutroph il-granulocyte infiltration of gastric mucosa disappeared in 2 months after bacterial eradication, Mononuclear cellular infiltration was disappearing with statistical significance up to the second, car and normal mucosa was o bserved in the majority of patients in the fourth year of follow-up. Degene ratively changed lymphoid aggregates were also present in the fourth year i n the antrum (12.5 per cent of patients) and in the body of stomach (14 per cent of patients), There was no significant change in antral intestinal me taplasia during the 4 years of follow-up. Antral atrophy declined significa ntly in the period from 1 to 3 years of follow-up. In conclusion, 3-4 years are needed for gastric mucosa to become normal after H. pylori eradication , although some residual lymphoid aggregates persist even after that period . Copyright (C) 1999 John Wiley & Sons, Ltd.