GASTROENTEROLOGY: Recovery of gastric function after Helicobacter pylori eradication in subjects with body atrophic gastritis: Prospective 4-year study

• Published in: Journal of gastroenterology and hepatology 2005-11, Vol.20 (11), p.1661-1666
• Main Authors: DI Mario, Francesco, Moussa, Ali M, Dal BO, Nadia, Caruana, Pietro, Pilotto, Alberto, Cavallaro, Lucas G, Cavestro, Giulia M, Iori, Veronica, Merli, Roberta, Franze, Angelo, Rugge, Massimo
• Format: Article
• Language: English
• Subjects: Helicobacter pylori
• ISSN: 0815-9319; 1440-1746
• DOI: 10.1111/j.1440-1746.2005.04051.x

Background:The relationship between Helicobacter pylori (H. pylori) eradication and atrophic changes in the gastric mucosa has not yet been fully defined. Although studies report a partial restoration of serum pepsinogen I (sPGI) levels after eradication, it is not clear if this finding reflects gastric mucosal healing on a morphological level. Aim:To assess alterations in gastric function after H. pylori eradication on moderate-severe body atrophic gastritis by determination of sPGI levels. Methods:Twenty-three dyspeptic patients, selected from 284 consecutive H. pylori positive patients, with histological features of moderate-severe body atrophic gastritis and sPGI < 25 mu g-L (11 men, mean age: 51.8 years, range: 29-79 years), underwent an upper gastrointestinal endoscopy with gastric biopsies and sPGI determination at baseline. All patients underwent eradication therapy. Serum pepsinogen I was measured again after 6 months, and at 1, 2, 3 and 4 years after eradication therapy. Results:Mean sPGI levels prior to eradication were 11.9 mu g-L (range: 4-23 mu g-L). Six months after eradication therapy, mean sPGI levels significantly increased to 17.4 mu g-L (P = 0.04). At the completion of the study, 4 years after eradication, sPGI levels increased from 17.4 to 32.7 mu g-L (P = 0.01). A significant progressive increase in sPGI levels was observed from 6 months to 1 year (17.4 to 23.9 mu g-L) and from 1 to 2 years (23.9 to 26.0 mu g-L, P = 0.01). Serum pepsinogen I levels higher than the cut-off value of 25 mu g-L were observed at various time-points: 6.3% of patients at 6 months (1-16), 33.3% (5-15) at 1 year, 50% (7-14) at 24 months, 66.7% (6-9) at 36 months and 87.5% (7-8) at 4 years. Conclusion:After H. pylori eradication, subjects with body atrophic gastritis showed long-term improvement of physiological gastric function, reflected by significantly and continually increasing sPGI levels over a 4-year period.