The effect of Helicobacter pylori eradication on duodenal gastric metaplasia

We investigated the incidence of duodenal gastric metaplasia and its respon se to Helicobacter pylori eradication in patients with duodenal ulcer or er osive duodenitis. Gastric and duodenal biopsies were taken from patients wi th endoscopically detected H. pylori positive duodenal ulcer or erosive duo denitis, and the presence and extent of duodenal gastric metaplasia was rec orded. Patients were given omeprazole 20 mg twice daily for 2 weeks, and am oxicillin Ig and clarithromycin 500 mg twice daily for 10 days, and then ra nitidine for a further 8 weeks. Biopsies were repeated 6 months after the s tart of treatment. Duodenal gastric metaplasia was initially present in 22 patients (52%) and was more frequent in ulcer patients than in duodenitis p atients, but not significantly so (69% versus 45%). After treatment, H. pyl ori was eradicated in 68% of duodenal gastric metaplasia patients and the d uodenum was normal endoscopically in 85% of these patients. Duodenal gastri c metaplasia was improved or eliminated in 12/15 H. pylori eradicators (80% ) and in 5/7 H. pylori non-eradicators (71%), a non-significant difference. The improvement in duodenal gastric metaplasia appeared to be independent of H. pylori eradication.