Improvement in Gastric Histology following Helicobacter PyloriEradication Therapy in Japanese Peptic Ulcer Patients

We aimed to determine if successful or failed eradication of Helicobacter pyloriwith triple therapy causes any difference in gastric mucosal histology. Japanese H. pylori-positivepatients with a healed peptic ulcer received high (n= 112) or low (n= 113) doses of triple therapy (omeprazole, amoxicillin and clarithromycin) for 1 week. Biopsies from the greater curvature of the central antrum and upper corpus were taken 6 weeks and 30 weeks after treatment completion, and gastric mucosal histology compared between successful (n= 171) and failed (n= 34) eradication groups. Morphological variables of gastritis were graded according to the updated Sydney System. Successful eradication therapy was defined as improvement in inflammation, neutrophil activity and atrophy; failed eradication therapy as improvement in inflammation and neutrophil activity only. Gastric mucosal atrophy gradually improved (in addition to improvements in inflammation and neutrophil activity) with successful eradication of H. pyloriinfection.Conclusions: Improvements in atrophy, inflammation and neutrophil activity were confirmed histopathologically following successful H. pylorieradication therapy, but improvements in inflammation and neutrophil activity were also seen after failed eradication therapy. No improvement in metaplasia was observed, irrespective of the success or failure of treatment. Since atrophy is known to be involved in the aetiology of gastric cancer, H. pylorieradication might prevent development of gastric cancer.