Campylobacter pylori has been associated closely with active
antral gastritis and
duodenal ulcer but its pathogenetic role remains uncertain. The present longitudinal study examined, prospectively, the endoscopic
antral biopsies of 45 patients with duodenal ulceration, taken before and after healing of the
duodenal ulcer, during remission and at relapse. The biopsies were examined for the activity and degree of chronic
inflammation of the
gastritis and for the occurrence and density of C. pylori by Warthin-Starry
stain. Before treatment the frequency of chronic active
antral gastritis was 100% and the occurrence of C. pylori was 97%. Compared with the pre-treatment state, there was no significant change in either the frequency and severity of
antral gastritis, or in the occurrence and density of the bacteria in the
antral mucosa at the time the
duodenal ulcer healed, during remission, or at relapse. The occurrence of the bacteria was significantly more frequent during remission, than at the time when the
ulcer had healed initially (P less than 0.05). These results suggest that the bacterium may not play an important pathogenetic role in
ulcer healing and relapse, when patients are managed using an H2-blocker.