Histological findings in a Helicobacter pylori infected dyspeptic patient population

Abstract

Objectives: The objective of this study was to compare endoscopic and histological findings with H. pylori infection in a dyspeptic patient population in Sri Lanka.

Methods: Eighty four dyspeptic patients who underwent upper gastro intestinal endoscopy at Endoscopy unit at Colombo South Teaching Hospital were enrolled. Two biopsy specimens were collected from the antrum during endoscopy. A biopsy was used for PCR targeting the glmM gene to identify H. pylori infection. The other specimen was fixed in formalin followed by paraffin embedding and stained with H&E stain. Histopathological changes were examined and gastritis was classified microscopically according to the modified Sydney system.

Results: Of the 84 dyspeptic patients 17 were positive by PCR and 15 patients were positive by histology for H. pylori infection. H. pylori infection was seen in 18% (11/62) of antral gastritis patients, 17% (2/12) of patients with gastric ulcer, 29% (2/7) of patients with gastric ulcer and gastritis. In the study population three patients had duodinitis but were negative for H. pylori infection. Of the total study population 69 had mild to moderate chronic non specific gastritis and 15 had H. pylori associated chronic gastritis according to histopathology. None of study population had gastric atrophy, mucosal ulceration or metaplasia by histological findings. All the biopsies of H. pylori-positive patients had infiltration of mononuclear cells and neutrophils.

Conclusions: The results show that 18% of patients with dyspeptic symptoms had H. pylori associated active chronic gastritis.