Mucosal biopsies were obtained from 116 asymptomatic volunteers (50% were male; mean age, 46 years; age range, 19-91 years) to study the prevalence of duodenal gastric
metaplasia (GM) and its association with
inflammation and Campylobacter pylori in a normal population. GM was identified in 25 subjects (22%). Eighty-three subjects (72%) had histologic
duodenitis, but in only 10 did the infiltrate include neutrophils (grade 2
duodenitis). C. pylori was found in the stomach in 36 subjects (31%), all of whom had
gastritis, but was not identified histologically in the duodenum. There were no significant differences between the overall frequency of
duodenitis and either GM or
antral C. pylori. Although the frequency of severe (grade 2)
duodenitis was not significantly different between those with and those without GM, grade 2
duodenitis was found in 9 of 36 subjects with
antral C. pylori but in only 1 of 80 without
antral C. pylori (P less than 0.001). These findings suggest that gastric
metaplasia is a common finding in the normal population and that grade 1
duodenitis is most likely clinically unimportant, whereas grade 2
duodenitis is usually associated with
antral C. pylori.