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Improvement of Precancerous Changes in the Stomach after Treatment of Helicobacter pylori Infection FREE

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The summary below is from the full report titled “Improvement in Atrophic Gastritis and Intestinal Metaplasia in Patients in Whom Helicobacter pylori Was Eradicated.” It is in the 6 March 2001 issue of Annals of Internal Medicine (volume 134, pages 380-386). The authors are T Ohkusa, K Fujiki, I Takashimizu, J Kumagai, T Tanizawa, Y Eishi, T Yokoyama, and M Watanabe.

Ann Intern Med. 2001;134(5):S87. doi:10.7326/0003-4819-134-5-200103060-00006
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What is the problem and what is known about it so far?

Helicobacter pylori is a bacterium associated with the development of inflammation (gastritis) and open sores (ulcers) in the lining of the stomach. Previous studies have shown that about one third of persons who have H. pylori infection for long periods (up to 32 years) develop abnormalities of the stomach lining, such as thinning (glandular atrophy) and abnormal types of cells (intestinal metaplasia). These abnormalities may be “precancerous,” which means that they could develop into cancer. It is not known whether these abnormalities would disappear if H. pylori infection were treated successfully.

Why did the researchers do this particular study?

To find out whether precancerous abnormalities of the stomach lining improve after successful treatment of H. pylori infection.

Who was studied?

163 patients who went to a medical center in Japan because of stomach discomfort and were found to have H. pylori infection.

How was the study done?

The researchers treated all patients with a 1-week course of antibiotics plus an additional medicine that decreases stomach acid. Before starting treatment and again 1 to 3 months and 12 to 15 months after treatment, patients had tests to look for the presence of H. pylori infection. At each of these visits, patients also had a test called upper gastrointestinal endoscopy to examine the stomach lining. This test involves passing an instrument through the patient's mouth down into the stomach. The researchers then took small samples (biopsies) of the stomach lining and examined these samples under a microscope.

What did the researchers find?

Of the 163 patients in the study, 115 were cured of H. pylori infection. Among these successfully treated patients, 89% of the patients who had glandular atrophy before treatment and 61% of the patients who had intestinal metaplasia before treatment showed improvement in the abnormalities of the stomach lining approximately 1 year after the H. pylori infection was treated. Among the patients in whom H. pylori infection was not cured, stomach abnormalities did not improve.

What were the limitations of the study?

The study was relatively small and followed patients for only about 1 year. The results of this study do not tell us whether the improvements seen in patients cured of H. pylori infection decrease the chances of developing stomach cancer in the future.

What are the implications of the study?

The stomach abnormalities found in some patients with H. pylori infection improve in the majority of those who are cured of the infection by antibiotic treatment.





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