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.