Gastric corpus atrophy following eradication of Helicobacter pylori

Background Atrophic gastritis can develop in patients with Helicobacter pyl ori infection leading to a reduction in basal acid output. Whether the atro phy that develops is reversible is controversial. Objective To investigate the effect of H. pylori eradication in infected su bjects who had developed atrophy of the corpus mucosa, Method Ten H. pylori positive patients with corpus atrophy were identified at oesophagogastroduodenoscopy (OGD). They received eradication therapy wit h amoxycillin, clarithromycin and omeprazole. Repeat OGD with biopsy was pe rformed at least 3 months later. Fasting plasma gastrin was measured at bas eline and at re-endoscopy. H. pylori eradication was confirmed by C-13 urea breath testing. Results Median time to re-endoscopy was 5 months. There was improvement in corpus atrophy in 50% of patients after H. pylori eradication, and a signif icant reduction in plasma gastrin (P = 0.03). The index patients had a sign ificant diminution of basal acid output compared to controls. Conclusion Corpus atrophy as defined by the Sydney System is reversible in some patients after H. pylori eradication. Improvement in atrophy is associ ated with a fall in fasting plasma gastrin levels. This may have implicatio ns in the prevention of gastric carcinoma. Eur J Gastroenterol Hepatol 13:3 77-382 (C) 2001 Lippincott Williams & Wilkins.