Alteration of histological gastritis after cure of Helicobacter pylori infection

Abstract

SUMMARYBackground: It is still disputed whether gastric atrophy or intestinal metaplasia improves after the cure of Helicobacter pylori infection. Aim: To clarify the histological changes after the cure of H. pylori infection through a literature survey. Methods: Fifty-one selected reports from 1066 relevant articles were reviewed. The extracted data were pooled according to histological parameters of gastritis based on the (updated) Sydney system. Results: Activity improved more rapidly than inflammation. Eleven of 25 reports described significant improvement of atrophy. Atrophy was not improved in one of four studies with a large sample size (> 100 samples) and in two of five studies with a long follow-

Usefulness of Magnifying Narrow-Band Imaging Endoscopy in the Helicobacter pylori-Related Chronic Gastritis

“…It is controversial whether IM would improve after H. pylori eradication [20]. In our study, histological assessment also showed that the atrophy score and IM in all patients with type 3 patterns were not improved 12 weeks after H. pylori eradication (data not shown).…”

“…Several reports show that H. pylori eradication leads to improvement of histological gastritis, such as the degree of chronic inflammation for at least several months [20]. Therefore, whether the gastric mucosal pattern seen by magnifying NBI endoscopy reflects these histological changes would be of great interest.…”

“…Type 1 and 2 mucosal patterns were highly prevalent in H. pylori- positive subjects, and both patterns show acute or chronic inflammation but not IM [15], suggesting that continuous distraction and regeneration of new vessels and edema due to severe inflammation may reflect an increased density of irregular microvessels and enlarged or prolonged pits. Since successful H. pylori eradication significantly improves chronic inflammation within several months [20], this improvement may reflect a change in magnifying NBI appearance.…”

Correlation of serum pepsinogen with histological atrophy following successful Helicobacter pylori eradication

“…[20][21][22][23] Hojo et al performed a meta-analysis of reported changes in histological gastritis following H. pylori eradication, and concluded that activity and inflammation are improved, and that gastric mucosal atrophy improves in part, but that it was difficult to analyse intestinal metaplasia due to problems with methodology, including statistics. 24 One reason for the absence of a unified approach to posteradication histological improvement is the lack of uniformity concerning the site of gastric mucosal biopsies and the degree of atrophy or intestinal metaplasia. In the present study, our findings regarding inflammation and activity in the gastric mucosa were Regenerating mucosa Helicobacter pylori similar for specimens taken from the greater curvature of the antrum, greater curvature of the upper corpus and lesser curvature of the mid-corpus, and similar changes were seen post-eradication.…”

Co-Occurrence of Helicobacter Pylori and Intestinal Metaplasia in Patients with Dyspepsia

“…HP eradication is important because intestinal metaplasia progresses to displasia and gastric cancer. After IM development, mucosal acidity changes and HP colonisation decreases, at which point HP eradication stops being useful [19]. Although local healing following IM can be seen in the antrum, there was no healing in the corpus in some reports [20].…”