PRECANCEROUS LESIONS IMPROVE IN MOST PATIENTS AFTER HELICOBACTER PYLORI ERADICATION.

Ohkusa T, Fujiki K, Takashimizu I, et al: Improvement in atrophic gastritis and intestinal metaplasia in patients in whom Helicobacter pylon was eradicated. Ann Intern Med 2001; 134:380-386

This single-blind, uncontrolled, prospective trial included 163 patients with dyspepsia and Helicobacter pylori infection. A 1-week course of a proton-pump inhibitor and antibiotic therapy was administered. Endoscopic examination with antral and corporal biopsy was done before treatment at 1 to 3 and 12 to 15 months after treatment. The updated Sydney System was used to grade gastritis, atrophy, and metaplasia. Among the 115 patients in whom H pylori was eradicated, inflammation and mean neutrophil activity decreased in 1 to 3 months, and glandular atrophy in the corpus and intestinal metaplasia in the antrum decreased in 12 to 15 months. Glandular atrophy in the corpus improved in 34 (89%) of 38 patients with atrophy before treatment. Intestinal metaplasia in the antrum improved in 28 (61%) of 46 patients who had metaplasia at baseline. In the 48 patients in whom eradication was unsuccessful, no significant histo-logic changes were seen.