Histology of chronic gastritis with and without duodenitis in patients with Helicobacter pylori infection

• Published in: Journal of clinical pathology Vol. 49; no. 5; pp. 377 - 380
• Main Authors: Phull, P S, Price, A B, Stephens, J, Rathbone, B J, Jacyna, M R
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd and Association of Clinical Pathologists 01-05-1996; BMJ; BMJ Publishing Group LTD
• Subjects: Adult; Aged; Aged, 80 and over; Biological and medical sciences; Biopsy; Chronic Disease; Duodenitis - complications; Duodenitis - microbiology; Duodenitis - pathology; Duodenum - microbiology; Duodenum - pathology; Female; Gastritis - complications; Gastritis - microbiology; Gastritis - pathology; Gastroenterology. Liver. Pancreas. Abdomen; Helicobacter Infections - pathology; Helicobacter pylori; Humans; Male; Medical sciences; Middle Aged; Other diseases. Semiology; Pyloric Antrum - microbiology; Pyloric Antrum - pathology; Severity of Illness Index; Stomach - microbiology; Stomach - pathology; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Human; Spirillales; Spirillaceae; Gastritis; Infection; Pathology; Concomitant disease; Chronic; Helicobacter pylori; Duodenitis; Bacteriosis; Digestive diseases; Bacteria; Intestinal disease; Comparative study; Gastric disease
• ISSN: 0021-9746; 1472-4146
• DOI: 10.1136/jcp.49.5.377

AIM: To compare the histological characteristics of Helicobacter pylori positive chronic gastritis in patients with and without associated duodenitis. METHODS: Gastric mucosal biopsy specimens were obtained from patients undergoing endoscopy for dyspepsia. Severity of gastritis and density of H pylori infection were graded according to the Sydney system. RESULTS: Of the 69 patients studied, 15 had normal histology, 22 had chronic gastritis only (77.3% H pylori positive), 21 had duodenitis (90.5% H pylori positive), and 11 had other diagnoses. In the H pylori positive patients, the median gastritis score was higher in the duodenitis group (6, range 3-9) than in the chronic gastritis only group (5, range 2-8), because of greater neutrophil activity scores in patients with duodenitis (median score 2 v 1). There were no differences in the density of H pylori infection, inflammation, atrophy, or intestinal metaplasia between patients with chronic gastritis only and those with duodenitis. CONCLUSIONS: These results suggest that H pylori positive patients with duodenitis have a more severe form of gastritis than those without associated duodenal inflammation. This is because of increased neutrophil activity, which seems to be independent of the density of H pylori infection.