Background: Non-ulcer dyspepsia (NUD) is a major health problem and one of the most common causes of morbidity and economic loss. The aim of the study was to determine the pattern of gastric mucosal histopathologic alterations and frequency of Helicobacter pylori in patients with NUD.Materials and Methods: Patients presenting to Gastroenterology Out Patient Department over a period of one year with symptoms of dyspepsia but without any endoscopic lesion were taken up for the study and evaluated by obtaining two gastric mucosal biopsy specimens each from antrum and body mucosa. The specimens were processed and examined histologically using the updated Sydney system.Results: Gastric biopsies from 102 patients (63 females and 39 males) with NUD were studied. Histological examination of gastric mucosal biopsies showed that 82.3% of NUD patients had histopathological features of gastritis. Chronic infl ammation was present in 84 (82.3%), activity was seen in 63 (61.7%), glandular atrophy was seen in 10 (9.8%) and intestinal metaplasia was seen in 4 (3.9%) patients with NUD on gastric biopsy. Maximum number of patients with NUD had Sydney score of less than 5 (68.6%).H pylori were identifi ed on gastric mucosal biopsies in 49 (48.0%) patients with NUD based on H & E and Geimsa stained sections.Conclusion: NUD is a clinical problem which occurs in both sexes in all age groups; prevalence being low below 20 years of age. Patients with this condition have a high frequency of gastric mucosal inflammation and H pylori infection.Asian Journal of Medical Sciences Vol.7(2) 2015 80-84

Introduction: Diseases related to gastric acid account for nearly one third of all health expenditure on gastrointestinal (GI) diseases. Evaluation of morphological features in chronic gastritis using updated Sydney system has not been systematically evaluated in India. So this study was done to interpret the histopathological changes in chronic gastritis using updated Sydney system and to correlate these pathological features with Helicobacter pylori (H. pylori) infection. Methods Gastric mucosal biopsies in a tertiary care centre in north India were evaluated using routine histopathological methods. Histopathological changes in patients with chronic gastritis were interpreted using updated Sydney system and correlated with H. pylori infection. Results: Chronic gastritis was seen in 89 cases. Histological grading of chronic gastritis was done by updated Sydney system. Chronic inflammation was present in 100% cases, neutrophilic activity in 39.33% cases, intestinal metaplasia in 7.87% cases, glandular atrophy in 12.36% cases and lymphoid follicles in 29.21% cases. H. pylori were identified in 50.56% cases of chronic gastritis. Association of H. pylori with pathological features in chronic gastritis was evaluated. The association of H. pylori with degree of chronic inflammation, neutrophilic activity and lymphoid aggregates was statistically significant. Conclusions: Histopathology should be performed in all cases of chronic gastritis. The updated Sydney classification provides an objective histological evaluation of chronic gastritis. The grade of chronic inflammation, neutrophilic activity and lymphoid follicles are significantly associated with H. pylori infection. So search for H. pylori should be initiated if neutrophils and lymphoid follicles are seen in the antral biopsies.