Histopathologic changes in patients with H. pylori positive chronic gastritis, before and after treatment

ABSTRACT

To evaluate histopathologic changes, between pre and post anti-Helicobacter pylori treatment using three different modalities, 108 patients with duodenal ulcer and H. pylori positive chronic gastritis were selected. Biopsies for histopathology and rapid urease test were taken from antrum and body and fundus regions, before and after treatment. Histopathologic evaluation was based on updated Sydney System. H. pylori in 45 of 108 patients [41.7%] became histologically eradicated, however rapid urease test was negative in 83 patients [76.8%]. The grade of gastritis and mean eosinophilic infiltration count were significantly decreased on post treatment biopsies in both eradicated and non eradicated patients [P value = 0.000,0.005 and 0.000,0.032 respectively]. Active inflammation was resolved in both eradicated and non eradicated groups [P Value = 0.000 and 0.002 respectively]. Density of H. pylori was significantly decreased in non eradicated group. Changes in atrophy and intestinal metaplasia were not statistically significant due to inadequate patients number, suffering from atrophy and/or intestinal metaplasia. Eradication of H. pylori is accompanied by significant histopathologic improvement. To evaluate reversibility of atrophy and intestinal metaplasia, larger study groups is needed. In comparison with histopathology, rapid urease test has low sensitivity