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Two‐ to four‐year histological follow‐up of gastric mucosa after Helicobacter pylori eradication
Author(s) -
Tepeš Bojan,
Kavčič Boris,
Zaletel Lijana K.,
Gubina Marija,
Ihan Alojz,
Poljak Mario,
Križman Igor
Publication year - 1999
Publication title -
the journal of pathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.964
H-Index - 184
eISSN - 1096-9896
pISSN - 0022-3417
DOI - 10.1002/(sici)1096-9896(199905)188:1<24::aid-path316>3.0.co;2-f
Subject(s) - helicobacter pylori , medicine , gastroenterology , antrum , intestinal metaplasia , gastric mucosa , stomach , gastritis , biopsy , metronidazole , atrophic gastritis , atrophy , antibiotics , biology , microbiology and biotechnology
In a 2‐ to 4‐year prospective study, the reversibility of gastritis after Helicobacter pylori eradication was analysed. Sixty‐three H. pylori ‐positive, chronic duodenal ulcer patients were studied after the successful eradication of bacteria in the period from 1990 to 1993. H. pylori eradication was obtained by triple antimicrobial regimens (colloidal bismuth subcitrate, amoxycillin, and metronidazole) applied for at least 14 days. The criteria for eradication were the absence of bacteria from two antral and two body of stomach biopsies stained with haematoxylin, eosin, and Warthin Starry, and a negative antral biopsy culture. The same diagnostic procedures were repeated, at regular follow‐up endoscopies, each year for up to 4 years. Neutrophil‐granulocyte infiltration of gastric mucosa disappeared in 2 months after bacterial eradication. Mononuclear cellular infiltration was disappearing with statistical significance up to the second year and normal mucosa was observed in the majority of patients in the fourth year of follow‐up. Degeneratively changed lymphoid aggregates were also present in the fourth year in the antrum (12·5 per cent of patients) and in the body of stomach (14 per cent of patients). There was no significant change in antral intestinal metaplasia during the 4 years of follow‐up. Antral atrophy declined significantly in the period from 1 to 3 years of follow‐up. In conclusion, 3–4 years are needed for gastric mucosa to become normal after H. pylori eradication, although some residual lymphoid aggregates persist even after that period. Copyright © 1999 John Wiley & Sons, Ltd.