Campylobacter pylori is not associated with gastroparesis

Abstract

There is a high incidence of Campylobacter pyloriin the gastric mucosa of patients with duodenal ulcer, gastric ulcer, and nonulcer dyspepsia. Factors that lead to development of this infection are unknown. We hypothesized that delayed solid-phase gastric emptying, a condition characterized by antral stasis, might predispose to Campylobacter pyloriinfection. We prospectively studied 51 patients with symptoms of gastroparesis using a solid-phase gastric emptying study and upper endoscopy. Patients were excluded if they had predominant symptoms of epigastric pain or an abnormal endoscopy. Three biopsies were obtained from the antrum and stained with H&E. When any inflammation was present, a Warthin-Starry stain was also performed. These were blindly examined for chronic inflammation, activity, and presence of Campylobacter pylori. Campylobacter pyloriwas not more common in patients with gastroparesis, documented by delayed gastric emptying, than in patients with a normal emptying study. On the contrary, there was a significantly lower incidence of Campylobacter pyloriin those with delayed emptying compared to those with normal emptying (5% vs 31%, P<0.05).Gastritis activity correlated closely with Campylobacterpresence. Inactive chronic gastritis with Campylobacterwas equally common in those with delayed or normal gastric emptying. Diabetics were no more likely to harbor Campylobacter pylorithan nondiabetics (16% vs 25%). The 5% incidence of Campylobacterin the gastroparesis group is less than, but approaches, that previously reported in asymptomatic controls. The 31% incidence of Campylobacterin the group with symptoms of gastroparesis but normal gastric emptying approaches that reported for nonulcer dyspepsia. Our data suggest that gastroparesis does not predispose to Campylobacter pyloriinfection or histologic chronic gastritis.