Two-hundred and ten consecutive patients undergoing routine gastroscopy were additionally investigated for evidence of Campylobacter pylori (C.p.). 106 patients were positive in one or more tests: 99.1% using a rapid
urease detecting test (CLO-test), 80.2% histology, 78.3% cytology and 60% culture. We found no difference between the CLO-test results from biopsies taken from different parts of the stomach in individual patients. C.p. was found in 100% of patients with significant chronic
antral gastritis, 67.7% with
gastric ulcers, 65% with
duodenal ulcers and in 12.1% of normal individuals. The C.p.
infection was apparently eliminated in 50% of cases treated with
bismuth subsalicylate (BSS) for four weeks. The combination of BSS with
amoxicillin,
tinidazole or an H2-receptor antagonist offered no advantage over BSS alone. Treatment with BSS led to improvement in symptoms and histological findings including healing of
ulcers in patients with or without persistent C.p.
infection. The recurrence of C.p.
infection after apparently successful treatment was, however, 75% in 4 weeks. In conclusion, C.p.
infection correlates strongly with the presence of chronic
gastritis, and significantly with gastric and duodenal ulceration. The best diagnostic approach is the combination of a rapid
urease detecting test and histology. C.p.
infection is of long duration and difficult to eliminate. The most effective treatment for C.p.
infection remains BSS as single agent.