Recent studies using histology alone in select patients have suggested that Helicobacter pylori-negative gastritis may be common.
Dr Helena Nordenstedt from Texas, USA investigated the prevalence of H. pylori among individuals with histologic gastritis.
The team reported that subjects between 40 and 80 years underwent elective esophagogastroduodenoscopy at a VA Medical Center.
Gastric biopsies were mapped from 7 prespecified sites and graded by 2 gastrointestinal pathologists, using the Updated Sydney System.
H. pylori-negative required 4 criteria, including negative triple staining at all 7 gastric sites, negative H. pylori culture, negative IgG H. pylori serology, and no previous treatment for H. pylori.
|41% had gastritis of at least grade 2 in at least one biopsy site |
|American Journal of Gastroenterology|
The researchers obtained data regarding tobacco smoking, alcohol drinking, nonsteroidal anti-inflammatory drug, and proton pump inhibitor use by questionnaire.
Of the 491 individuals enrolled, 41% had gastritis of at least grade 2 in at least one biopsy site or grade 1 in at least two sites.
The team of doctors observed that 41 had H. pylori-negative gastritis.
The doctors noted that most had chronic gastritis, 5 had active gastritis, and 6 had both.
H. pylori-negative gastritis was approximately equally distributed in the antrum, corpus, and both antrum and corpus.
Past and current proton pump inhibitor use was more frequent in H. pylori-negative vs. H. pylori-positive gastritis.
Dr Nordenstedt's team concludes, "We used multiple methods to define non-H. pylori gastritis and found it in 21% of patients with histologic gastritis."
"While proton pump inhibitor use is a potential risk factor, the cause or implications of this entity are not known."