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Background  Gastric epithelial hyper-proliferation was reported in patients with  Helicobacter pylori  ( H. pylori )–infected gastric mucosa with intestinal metaplasia (IM) changes. In patients with gastric ulcer (GU) and IM, the GU may have a different healing rate in comparison to patients without IM. This study aimed to compare the difference in GU healing between  H. pylori– infected patients with IM and those without IM.    Methods  We retrospectively analyzed patients at the Keelung Chung Gung Memorial Hospital during the period from March 2005 to January 2011. The inclusion criteria were: 1) endoscopic findings of GU and biopsy histological examination plus rapid urease test indicating  H. pylori  infection; 2) gastric IM adjacent to a GU but with no atrophic gastritis changes; 3) patients receiving  H. pylori  eradication triple therapy and 8 weeks of maintenance therapy with a proton pump inhibitor; and 4) patients receiving follow-up endoscopy within the 3 rd  and the 4 th  months after treatment.    Results  In total, 327 patients with GU and  H. pylori  infection (136 with IM and 191 without IM) were included. Patients with IM had a higher GU healing rate than those without IM (91.9% vs. 84.3%,  P  = 0.040). Multivariate logistical regression analysis revealed that failure of  H. pylori  eradication (Odds = 4.013, 95% CI: 1.840–8.951,  P  < 0.001) and gastric IM (Odds = 0.369, 95% CI: 0.168–0.812,  P  = 0.013) were the predictors of non-healing GU following treatment.    Conclusions  Patient with gastric IM change may have a higher GU healing rate than those without gastric IM. However, successful  H. pylori  eradication is a more important factor for GU healing than gastric IM.

Analyzing the influence of gastric intestinal metaplasia on gastric ulcer healing in Helicobacter pylori–infected patients without atrophic gastritis