Effect of Helicobacter pylori eradication on 24-hour gastric pH and duodenal gastric metaplasia

Published data on the regression of the extent of duodenal gastric metaplas ia (DCM) after the eradication of Helicobacter pylori infection and the nor malization of the organism-induced alterations in gastric physiology are sc anty and controversial, Therefore, we decided to assess the circadian patte rn of gastric acidity and the degree of DGM before and one year after H. py lori eradication in a group of duodenal ulcer patients. Fifteen consecutive H. pylori-positive patients with endoscopically proven duodenal ulcer were recruited fur this study. The diagnosis of H. pylori infection was based o n CLO-test and histology, and DGM was assessed on four bulb biopsies taken before and one year after H. pylori eradication. At the same time, gastric pH was measured by 24-hr continuous intraluminal recording. H. pylori eradi cation was ascertained by means of concomitant negative CLO-test and histol ogy performed both four weeks after the end of the eradicating treatment an d at the one-year endoscopic control. After successful cure, all patients d iscontinued any antiulcer medication. The mean 24-hr gastric pH was 1.7 +/- 0.4 before and 1.6 +/- 0.4 after one year of H. pylori eradication (P = 0. 75). DGM improved in three cases, worsened in four cases, and was unchanged in eight cases at the one-year control (P = 0.87). No correlation was foun d between 24-hr gastric pH and DGM (P = NS) both at baseline and one year a fter eradication, Our results show that neither circadian gastric acidity n or DGM change significantly one year after H. pylori eradication in duodena l ulcer patients. Thus, the disappearance of H. pylori infection does not d etermine any increase in gastric pH and any reversal of gastric-type epithe lium in the duodenum.