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There has been an accumulation of data regarding the chemopreventive effects of  Helicobacter pylori  ( H. pylori ) eradication. However, it remains unclear how  H. pylori  infection causes gastric cancer (GC) and how  H. pylori  eradication can prevent GC. Atrophic gastritis (AG) and intestinal metaplasia (IM) are known as precancerous lesions which mainly lead to intestinal-type GC but to some extent, can also lead to diffuse-type GC. The most important mechanism of AG/IM is  H. pylori -induced chronic gastritis. Thus, the reversibility of AG and IM by  H. pylori  eradication therapy is very important in the prevention of GC. There have been many studies providing data supporting the improvement of AG by the eradication of  H. pylori  to some extent. In contrast, IM has been regarded as “the point of no return.” However, more recent studies have implied the improvement of IM after eradication, suggesting the importance of early eradication therapy in reversible histological status. In this review, we focused on the reversibility of AG and IM by  H. pylori  eradication and tried to investigate the predicting factors for the improvement of AG and IM including age, sex, smoking, and diet, as well as  H. pylori  infection.

Significance of Helicobacter pylori Eradication on Atrophic Gastritis and Intestinal Metaplasia