Helicobacter pylori, gastritis and duodenitis in the healing process of duodenal ulcer.

The occurrence of antral gastritis, duodenitis, gastric metaplasia and Helicobacter pylori (H. pylori) were compared between 63 endoscopically proven duodenal ulcer (DU) patients and 34 non-ulcer dyspepsia (NUD) patients with no ulcer history and no ulcer present as documented by endoscopy. The DU group showed a significantly higher rate of active antral gastritis (89% vs 41% p less than 0.05), a higher antral H. pylori carrying rate (76% vs 27% p less than 0.01), a higher rate of active chronic duodenitis (75% vs 32% p less than 0.05), and a higher rate of gastric metaplasia in the duodenal bulb (68% vs 27% p less than 0.05) than the NUD group. The H. pylori carrying rate in the bulb was 16% in the DU group and 0% in the NUD group. The difference is evident, although it is statistically insignificant. All 10 cases carrying H. pylori in the duodenum in the DU group had active chronic duodenitis with gastric metaplasia. Further evaluation of the variables (rate of active antral gastritis and duodenitis and the carrying rate of H. pylori in the antrum and bulb) showed no difference between different ulcer stages (active, healing, or scarred). The above findings strongly suggest a close relation between H. pylori and duodenal ulcer. However, the low occurrence rate of the bacteria in the bulb can only indicate a partial etiologic role of the bacteria in DU. No improvement in antral gastritis, duodenitis and H. pylori occurrence, despite the healing of an ulcer, is in agreement with the naturally high recurrence rate of duodenal ulcers.