Prevalence of gastric metaplasia in the duodenal bulb is low in Helicobacter pylori positive non-ulcer dyspepsia patients

Background Gastric metaplasia in duodenum is a common phenomena in duodenal ulcer patients. However, the role of gastric metaplasia in patients with n on-ulcer dyspepsia is not clear. It is not known either, whether Helicobact er pylori infected non-ulcer patients who are CagA-seropositive have gastri c metaplasia in duodenum more often than. CagA-negative patients. Aims. To compare prevalence of gastric metaplasia in duodenum in non-ulcer dyspepsia patients according to Helicobacter pylori status. Patients and methods. A series of 400 unselected dyspeptic patients in prim ary care were investigated, Patients with no endoscopic evidence of organic disease (n=236) were enrolled in the study. Duodenal bulb and gastric biop sies were collected, as well as blood samples for Helicobacter pylori deter mination. Results. There were no differences between CagA-seropositive and -seronegat ive Helicobacter pylori infected patients as far as concerns gastric metapl asia in duodenal bulb (20% vs 25%). Helicobacter pylori negative non-ulcer patients more often had gastric metaplastic changes (46%, p<0.0001) in duod enum. Conclusion. Helicobacter pylori infection has no major role in development of gastric metaplasia in duodenal bulb in non-ulcer dyspeptic patients. Fur thermore, it does not result in positive CagA-serology an increased risk fo r gastric metaplasia compared with CagA-seronegative cases.