Helicobacter pylori eradication therapy improves atrophic gastritis and intestinal metaplasia: a 5-year prospective study of patients with atrophic gastritis.

Abstract

AIM:

: To investigate the effect of the eradication of Helicobacter pylori on histological gastritis.

METHODS:

: Twenty-six patients with moderate to severe atrophy received successful eradication therapy of H.pylori. Four patients dropped out and 22 were followed up prospectively for 5 years. The grades of gastritis were estimated from gastric biopsy specimens. The grade of intestinal metaplasia was also evaluated by dye-endoscopy using methylene blue (methylthioninium chloride). The serum levels of pepsinogen, gastrin and anti-parietal cell antibody were also determined.

RESULTS:

: The grades of atrophy decreased in patients with successful eradication therapy in the gastric corpus (before vs. 5 years after eradication, 2.09 +/- 0.15 vs. 0.91 +/- 0.17; P < 0.01) and in the antrum (2.14 +/- 0.17 vs. 1.36 +/- 0.17; P < 0.01). The levels of intestinal metaplasia were also decreased in the corpus (0.91 +/- 0.24 vs. 0.50 +/- 0.16; P < 0.05) and in the antrum (1.41 +/- 0.20 vs. 1.00 +/- 0.16; P < 0.05), which was also demonstrated by the methylene blue (methylthioninium chloride) staining method (33.4 +/- 8.2% vs. 23.0 +/- 6.5%; P < 0.05). The improvement of corpus atrophy correlated well with the high serum level of pepsinogen I (P = 0.005), but showed no correlation with the levels of anti-parietal cell antibody.

CONCLUSIONS:

: These results suggest that gastric atrophy and intestinal metaplasia are reversible events in some patients.

• Authors: M Ito, K Haruma, T Kamada, M Mihara, S Kim, Y Kitadai, M Sumii, S Tanaka, M Yoshihara, K Chayama
• Journal: Alimentary pharmacology & therapeutics (Aliment Pharmacol Ther) Vol. 16 Issue 8 Pg. 1449-56 (Aug 2002) ISSN: 0269-2813 [Print] England
• PMID: 12182744 (Publication Type: Clinical Trial, Journal Article)

Chemical References

• Anti-Bacterial Agents
• Biomarkers
• Gastrins
• Pepsinogens
• Methylene Blue

Topics

• Adult
• Aged
• Anti-Bacterial Agents (therapeutic use)
• Biomarkers (blood)
• Drug Therapy, Combination
• Female
• Follow-Up Studies
• Gastrins (blood)
• Gastritis, Atrophic (drug therapy, microbiology, pathology)
• Helicobacter Infections (complications, drug therapy)
• Helicobacter pylori
• Humans
• Intestines (pathology)
• Male
• Metaplasia (drug therapy, microbiology, pathology)
• Methylene Blue
• Middle Aged
• Pepsinogens (blood)
• Precancerous Conditions (drug therapy, microbiology, pathology)
• Prognosis
• Prospective Studies
• Stomach Neoplasms (blood, microbiology, pathology)