DISTINCT PROFILES OF GASTRITIS IN DYSPEPSIA SUBGROUPS - THEIR DIFFERENT CLINICAL-RESPONSES TO GASTRITIS HEALING AFTER HELICOBACTER-PYLORI ERADICATION

Background: A contribution of Helicobacter pylori gastritis to the pathogenesis of non-ulcer dyspepsia (NUD) remains uncertain. Methods: Administration of an appropriate clinical questionnaire followed by endoscopy allowed us to select, among 139 outpatients with dyspepsia, 87 non-ulcer dyspepsia patients with more severe and group-distinctive symptoms, 35 of whom were classified as having ulcer-like (ULD), 38 as dysmotility-like (DLD), and 14 as reflux-like dyspepsia (RLD). Biopsy specimens were evaluated for H. pylori gastritis in accordance with the Sydney system. The 70 H. pylori-positive cases were treated with omeprazole, 20 mg twice daily, and amoxycillin, 1 g three times daily for 2 weeks. Results: Higher rates of H. pylori colonization were found histologically in the gastric mucosa of ULD (91%) and RLD (86%) than in that of DLD (68%) or asymptomatic (43%) patients. ULD differed from RLD patients in their higher score of antritis activity. Three and 6 months af ter H. pylori eradication ULD (but not DLD) showed significant regression of dypspetic symptoms scores. Conclusions: It seems likely that H. pylori gastritis, with special reference to active antritis, is among causative factors of ULD. Its role in the pathogenesis of RLD and DLD needs further investigation.