Improved fold width and increased acid secretion after eradication of the organism in Helicobacter pylon associated enlarged fold gastritis

Abstract

This study examined the effects of eradication of Helicobacter pylori (H pylori) infection on gastric mucosal morphology and acid secretion. Sixteen H pylori positive patients with enlarged gastric body folds were divided into two groups: (a) patients with moderate enlargement (fold width: 6 to 10 mm, n=8) and (b) patients with severe enlargement (>10 mm, n=8). After successful treatment, gastric body fold width was reduced in both groups (p<0.01) with an associated decrease in inflammatory infiltrates in the body mucosa (p<0.01 and p<0.05). Basal acid output and tetragastrin stimulated maximal acid output (mean (SEM)) in all 16 patients significantly increased from 1·1 (0·5) to 2·9 (0·9) mmol/h (p<0.05) and from 5·4 (1·3) to 18·7 (2·3) mmol/h (p<0·01), respectively, with a significant decrease in fasting serum gastrin concentrations, from 127·1 (16·1) to 59·6 (3·8) pg/ml (p<0·01). The increase in acid secretion after eradication of H pylori was more noticeable in the severe group, who had shown lower acid secretion and higher serum gastrin concentrations (p<0·05) before eradication, than the increase seen in the moderate group. The decreases in ammonia nitrogen content seen after eradication were significant in basal (from 0·91 (0·17) to 0·37 (0·08) mmol/h, p<0·05) and stimulated gastric secretions (from 1·57 (0·19) to 0·37 (0·13) mmol/h, p<0·01), although these changes were too small to explain the increases in basal acid output and maximal acid output. These results suggest that inflammation of the gastric body mucosa caused by H pylori infection is associated with enlarged gastric body folds and inhibition of acid secretion in H pylori positive patients with enlarged gastric body folds.