Whether the regression of gastric
metaplasia in the duodenum can be achieved after eradication of Helicobacter pylori is not clear. The aim of the present study was to investigate the relationship between H. pylori
infection and gastric
metaplasia in patients with endoscopic diffuse nodular
duodenitis. Eighty-six patients with endoscopically confirmed nodular
duodenitis and 40 control patients with normal duodenal appearance were investigated. The H. pylori-positive patients with
duodenitis received anti-H. pylori triple
therapy (20 mg
omeprazole plus 250 mg
clarithromycin and 400 mg
metronidazole, all twice daily) for one week. A control endoscopy was performed 6 months after H. pylori treatment. The H. pylori-negative patients with
duodenitis received 20 mg
omeprazole once daily for 6 months and a control endoscopy was performed 2 weeks
after treatment. The prevalence of H. pylori
infection was 58.1%, and the prevalence of gastric
metaplasia was 57.0%. Seventy-six patients underwent endoscopy again. No influence on the endoscopic appearance of nodular
duodenitis was found after eradication of H. pylori or
acid suppression
therapy. However, gastric
metaplasia significantly decreased and complete regression was achieved in 15/28 patients (53.6%) 6 months after eradication of H. pylori, accompanied by significant improvement of other histological alterations. Only mild chronic
inflammation, but not gastric
metaplasia, was found in the control group, none with H. pylori
infection in the duodenal bulb. Therefore, H. pylori
infection is related to the extent of gastric
metaplasia in the duodenum, but not to the presence of diffuse nodular
duodenitis.