Morphometric estimation of acid output in duodenal ulcer associated with Helicobacter pylori infection

OBJECTIVE: to determine the changes in acid output before and after eradica tion therapy in patients with duodenal ulcer associated with Helicobacter p ylori infection. METHOD: the subjects of this prospective study were 16 patients with acute duodenal ulcer at endoscopy and H. pylori infection determined by rapid ure ase test and histology. They were randomly assigned to receive treatment wi th pantoprazole 40 mg b.i.d., clarithromycin 500 mg b.i.d. and amoxicillin 1 g b.i.d. during 7 or 14 days. Endoscopic examination and biopsy were repe ated 4 weeks after treatment ended. The changes in acid output before and a fter treatment were calculated by the morphometric quantification of pariet al cell canaliculi from the gastric corpus. To this end 20 parietal cells f rom the medial glandular zone were selected and canalicular index was calcu lated, before and after eradication therapy, with a morphometric method bas ed on automatic analysis of histological images. RESULTS: canalicular index was 26.4 +/- 1.4 (mean +/- standard error of the mean) before treatment, and 20.5 +/- 1 (p < 0.01) after therapy. CONCLUSIONS: morphometric analysis showed a decrease in acid output in pati ents with duodenal ulcer associated with H. pylori infection 4 weeks after eradication therapy with clarithromycin, amoxicillin and pantoprazole.