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 21 November 2017

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News

Alterations in the gastric mucosa after Helicobacter pylori eradication

Neutrophil infiltration improves rapidly after Helicobacter pylori eradication, find doctors in the July issue of Digestive Endoscopy.

News image

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In this study, doctors from Japan investigated long-term changes in the gastric mucosa after Helicobacter pylori eradication.

They looked at histological and endoscopic findings of the gastric mucosa before and 5 years after eradication.

There were 59 H. pylori-positive patients with peptic ulcer included in the study. All patients were followed for 5 years after H. pylori eradication.

Acid-suppressive drugs were not given after eradication.

Patients underwent endoscopic examination, as well as tests for H. pylori infection at 1 to 2 months, 1 year, and 5 years after eradication.
There was no change in the degree of intestinal metaplasia.
Digestive Endoscopy

The team also took biopsy samples were taken from the greater curvature of the gastric antrum and upper corpus. These were scored histologically according to the Updated Sydney System.

The atrophic border was evaluated endoscopically based on Kimura and Takemoto's classification.

In addition, the team scored levels of antral erosion and spotty redness in the corpus.

The doctors found that neutrophil infiltration was significantly reduced 1 to 2 months after eradication. This remained at the reduced level over the next 5 years.

In addition, mononuclear cell infiltration began to decrease 1 to 2 months after eradication and continued to subside 1 year and 5 years later.

The team also found that the histological atrophy of the gastric glands was significantly improved 1 year and 5 years after eradication. However, there was no consistent alteration in the atrophic border.

They determined that there was no change in the degree of intestinal metaplasia for 5 years.

In some patients, antral erosion became more conspicuous after 5 years.

The doctors observed spotty redness in the corpus in 15% of cases before eradication, and in 10% 1 year later.

Dr Yoshio Oda and colleagues concluded, "Neutrophil infiltration improved rapidly after H. pylori eradication in contrast with mononuclear cell infiltration, which decreased gradually over 5 years".

"Glandular atrophy improved in the long term, whereas intestinal metaplasia had not altered 5 years after eradication".

"Spotty redness in the gastric corpus disappeared in all cases after eradication, suggesting that it is an endoscopic finding related to H. pylori infection".

Dig Endosc 2004: 16(3): 213-8
07 June 2004

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