Improvement in atrophic gastritis and intestinal metaplasia in patients in whom Helicobacter pylori was eradicated

Ann Intern Med. 2001 Mar 6;134(5):380-6. doi: 10.7326/0003-4819-134-5-200103060-00010.


Background: Glandular atrophy and intestinal metaplasia are precancerous lesions; whether Helicobacter pylori eradication affects these lesions is controversial.

Objective: To determine whether H. pylori eradication is associated with improvement in glandular atrophy and intestinal metaplasia after at least 1 year.

Design: Single-blind, uncontrolled prospective trial.

Setting: Academic gastroenterology clinic in Japan.

Patients: 163 consecutive patients with dyspepsia and H. pylori infection.

Intervention: One-week course of a proton-pump inhibitor and antibiotic therapy.

Measurements: Endoscopic examination with antral and corporal biopsy was done before treatment and at 1 to 3 and 12 to 15 months after treatment. Gastritis, atrophy, and metaplasia were graded according to the updated Sydney System.

Results: In the 115 patients in whom H. pylori was eradicated, inflammation and mean neutrophil activity had decreased by 1 to 3 months, and both glandular atrophy in the corpus and intestinal metaplasia in the antrum had decreased by 12 to 15 months. Glandular atrophy in the corpus improved in 34 (89%) of 38 patients with atrophy before treatment, and intestinal metaplasia in the antrum improved in 28 (61%) of 46 patients who had metaplasia at baseline. In the 48 patients in whom eradication was unsuccessful, no significant histologic changes were observed.

Conclusion: In the year after successful H. pylori eradication, precancerous lesions improved in most patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • 2-Pyridinylmethylsulfinylbenzimidazoles
  • Adult
  • Aged
  • Anti-Bacterial Agents
  • Anti-Ulcer Agents / therapeutic use
  • Biopsy
  • Drug Therapy, Combination / therapeutic use
  • Dyspepsia / drug therapy
  • Dyspepsia / microbiology
  • Dyspepsia / pathology
  • Endoscopy, Gastrointestinal
  • Female
  • Follow-Up Studies
  • Gastritis, Atrophic / drug therapy*
  • Gastritis, Atrophic / microbiology
  • Gastritis, Atrophic / pathology*
  • Helicobacter Infections / drug therapy*
  • Helicobacter Infections / pathology*
  • Humans
  • Intestines / pathology*
  • Lansoprazole
  • Male
  • Metaplasia
  • Middle Aged
  • Omeprazole / analogs & derivatives*
  • Omeprazole / therapeutic use
  • Precancerous Conditions / drug therapy*
  • Precancerous Conditions / microbiology
  • Precancerous Conditions / pathology*
  • Prospective Studies
  • Proton Pump Inhibitors
  • Single-Blind Method


  • 2-Pyridinylmethylsulfinylbenzimidazoles
  • Anti-Bacterial Agents
  • Anti-Ulcer Agents
  • Proton Pump Inhibitors
  • Lansoprazole
  • Omeprazole