Helicobacter pylori causes chronic active
gastritis and is thought to be associated with the development of gastric
atrophy, intestinal
metaplasia and
carcinoma. As the effect of H. pylori eradication on this process is poorly understood, we sought to determine the long-term effects of H. pylori eradication on gastric histology. Fifty-four patients with duodenal ulceration associated with H. pylori
infection received H. pylori eradication
therapy in 1985/86 and either remained infected (n = 22) or had the
infection eradicated (n = 32); patients were followed up by endoscopy with gastric
antral biopsy for 7.1 years (mean). Histopathological analysis of gastric
antral mucosa from patients rendered H. pylori-negative revealed a marked decrease in both inflammatory cells within the lamina propria and intraepithelial neutrophils and an increase in epithelial mucinogenesis. Gland
atrophy remained unchanged in both H. pylori-positive and -negative patients. When examined for the presence and severity of intestinal
metaplasia, there was neither a difference between the two patient groups nor a change with time. These data demonstrate that significant long-term improvements in gastric histology accompany H. pylori eradication when compared with histology in patients with
persistent infection. Whether this confers a protective effect by reducing the risk of gastric
carcinoma remains unknown.