Changing Patterns of Helicobacter pylori Gastritis in Long-Standing Acid Suppression (original) (raw)
Helicobacter pylori colonization and associated inflammation are influenced by local acid output. Infected subjects with acid-related diseases, such as gastroesophageal reflux disease (GERD) are likely to have an antral-predominant gastritis. We hypothesized that long-term acid suppression would result in relatively greater bacterial colonization in the corpus leading to diffuse or corpus-predominant gastritis and that this would be prevented by prior H. pylori eradication. Materials and Methods. To investigate this, we conducted a prospective, double-blind trial of the effect on gastric histology of 12-month maintenance treatment with omeprazole in H. pylori -positive GERD patients randomly assigned to either an eradication or omeprazole-alone regime. A control group of 20 H. pylori -negative GERD patients also received omeprazole throughout the study period. Biopsies taken at baseline and at 12 months were graded "blind" by a single observer according to the updated Sydney System. The 41 H. pylori -positive subjects with grade B or C esophagitis were randomly assigned (20 to omeprazole alone, 21 to erad-
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