Helicobacter pylori infection of gastric mucin cell metaplasia: the duodenum revisited.

The histological material of 158 Billroth II gastrectomy specimens, used for a former study that established a relationship between duodenal ulcers and the presence of gastric metaplastic epithelium in the duodenal bulb, was reinvestigated for the presence of Helicobacter pylori. The results show that in all duodenal ulcer patients with gastric mucin cell metaplasia H. pylori colonized the metaplastic epithelium accompanied by an inflammatory response. The intestinal mucosa was always negative for H. pylori. H. pylori-positive patients also had the micro-organism in their gastric antrum. The results further support the hypothesis that infection of gastric mucosa in the bulb by H. pylori underlies duodenal ulcer disease.