Helicobacter pylori infection and gastric function in patients with fundicatrophic gastritis

In the present study we evaluated the relation among histology, H. pylori, IgG to H. pylori, gastric emptying, and acid secretion in 43 patients with fundic atrophic gastritis. On the basis of gastric acid secretion, patients were divided into three subgroups: patients with preserved acid secretion (Group 1), patients with hypochlorhydria (Group 2), and patients with achlo rhydria (Group 3). Fundic glandular atrophy was more severe in hypoachlorhy dric patients than in those with preserved acid secretion (P < 0.05 vs Grou p 2, P < 0.005 vs Group 3). H. pylori colonization was found in 94% of pati ents in Group 1, in 61% of patients in Group 2, and in only 8% of patients in Group 3 (P < 0.001 vs Group 1, P < 0.05 vs Group 2). Conversely, serolog ical positivity to H. pylori was high in all three subgroups of patients (1 00% in Group 1, 77% in Group 2, 92% in Group 3). Gastric emptying was delay ed in atrophic patients, particularly in those with hypoachlorhydria. Our d ata suggest that fundic atrophic gastritis represents a possible end stage of H. pylori infection, characterized by a progressive disappearance of the bacterium and a progressive deterioration of gastric functions.