ENDOSCOPIC AND HISTOLOGICAL ASPECTS OF HELICOBACTER PYLORI GASTRITIS

Aims:

The responsibility for Helicobacter pylori (HP) in the genesis of peptic ulcer is well established. Its role in gastric carcinogenesis has also been demonstrated. The purpose of our work was to determine the endoscopic and histological aspects of HP gastritis.

Methods:

This is a retrospective study including all the patients who had a first upper gastrointestinal endoscopy (UGE) with 5 gastric biopsies between January 2015 and September 2018. The histological examination allowed us in addition to the existence of HP, studying the activity of gastritis, gastric atrophy and intestinal metaplasia according to the Sydney System.

Results:

Among 355 patients who had UGE with gastric biopsies, 248 patients (96 men and 152 women, mean age 47 years) had chronic HP gastritis (70%). Sixty patients (20%) were smokers. Anemia was present in 80 patients (22%). Congestive or erythematous gastritis was the most common endoscopic lesion (n = 158, 63.7%). Other endoscopic findings were: nodular gastritis (n = 49), erosive gastritis (n = 13), ulcerated gastritis (n = 17), congestive gastro-bulbitis (n = 16), bulbitis erosive (n = 12), gastric ulcer (n = 9) and ulcerated bulbitis (n = 9). Chronic gastritis was active in 90% of cases with mild to moderate activity in most patients (88%). The prevalence of gastric atrophy was 19%. It was present in the fundus in 3.6% of cases. The prevalence of intestinal metaplasia was 9%. Only one patient had low grade dysplasia. The presence of HP was associated with smoking (p = 0.04) and the presence of anemia (p = 0.05).

Conclusions:

In our series, the prevalence of chronic HP gastritis was 70%. The presence of HP was associated with smoking and anemia. Intestinal metaplasia, fundic atrophy and dysplasia were present in 9%, 3.6% and 0.5% of cases, respectively.