Abstract
Campylobacter pyloridis has been associated with antral gastritis and duodenal ulcer. To study the pathogenetic role of these organisms in duodenal ulcer, endoscopic biopsies, two from the first part of duodenum, four from antrum, and four from body and fundus, were taken before and after four weeks of cimetidine treatment (1.2 g/day) from 67 patients with active duodenal ulcer. The biopsies were examined for the presence and severity of any inflammation by two independent pathologists in the absence of any clinical information and for the occurrence and density ofCampylobacter pyloridis by culture and Warthin-Starry stain. Before treatment, inflammation was present in 71.1, 100, and 25.8%, while the organisms were present in 34.3, 91.0, and 79.1% of the duodenal, antral, and fundal biopsies, respectively. With complete healing of duodenal ulcer, inflammation was present in 48.9, 98.2, and 30.2%, while the organisms were present in 25, 76.7, and 63.3% of the respective mucosae. With ulcer healing, duodenitis became significantly milder (P<0.05). With improvement of gastritis and duodenitis, there was no significant change in the occurrence and density ofCampylobacter pyloridis. These findings indicate that healing of duodenal ulcer is not influenced by the presence ofCampylobacter pyloridis, which is frequently found in the gastroduodenal mucosa of patients with duodenal ulcer, but does not appear to be associated with mucosal inflammation except in the antrum.
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References
Warren JR, Marshall B: Unidentified curved bacilli on gastric epithelium in active chronic gastritis. Lancet 1:1273–1275, 1983
Rollason TP, Stone J, Rhoses JM: Spiral organisms in endoscopic biopsies of the human stomach. J Clin Pathol 37:23–26, 1984
Price AB, Levi J, Dolby JM, Dunscombe PL, Smith A, Clark J, Stephenson ML:Campylobacter pyloridis in peptic ulcer disease: Microbiology, pathology, and scanning electron microscopy. Gut 26:1183–1188, 1985
Kaldor J, Tee W, McCarthy P, Watson J, Dwyer B: Immune response to campylobacter pyloridis in patients with peptic ulceration. Lancet 1:921, 1985
Marshall BJ, McGechie DB, Francis GJ, Utley PJ: PyloricCampylobacter serology. Lancet 2:281, 1984
Thomas JM, Poynter D, Gooding C, Woodings DF, Selway S, Cook AR, Hill MJ, Misiewicz JJ: Gastric spiral organisms. Lancet 2:100, 1984
Ho J, Lui I, Hui WM, Ng MMT, Lam SK: A study on the correlation of duodenal-ulcer healing withCampylobacter-like organisms. J Gastroenterol Hepatol 1:69–74, 1986
Lam SK, Koo J: Accurare prediction of duodenal-ulcer healing rate by discriminant analysis. Gastroenterology 85: 403–412, 1983
American Armed Forces Institute of Pathology: Warthin-Starry method for spirochaetes and Donovan bodies.In Manual of Histologic Staining Methods, 3rd ed., 1968, pp 238–240
Hui WM, Lam SK, Ho J, Ng MMT, Lui Irene, Lai CL, Lok Anna, Lau WY, Poon GP, Choi S, Choi TK: Chronic antral gastritis in duodenal ulcer. Natural history and treatment with prostaglandin E1. Gastroenterology 91:1095–1101, 1986
Marshall BJ, Warren JR: Unidentified curved bacilli in the stomach of patients with gastritis and peptic ulceration. Lancet 1:1311–1315, 1984
Buck GE, Gourley WK, Lee WK, Subramanyam K, Latimer JM, DiNuzzo AR: Relation ofCampylobacter pyloridis to gastritis and peptic ulcer. J Infect Dis 153(4):664–669, 1986
Snedecor GW, Cochran WG: Statistical Methods, 6th ed. Iowa State University Press, Ames, Iowa, 1967
Philips AD, Hine KR, Holmes GKT, Woodings DF: Gastric spiral bacteria. Lancet 2:100–101, 1984
Lee FI, Samloff IM, Hardman M: Comparison of tripotassium dicitratobismuthate tablets with ranitidine in healing and relapse of duodenal ulcers. Lancet 1:1299–1302, 1985
Marshall BJ, McGechie DB, Rogers PA, Glancy RJ: PyloricCampylobacter infection and gastroduodenal disease. Med J Aust 142:439–444, 1985
Hislop IG, Glancy R, Armstrong J: Histological improvement of active chronic gastritis in patients treated with DeNol. Aust NZ J Med 14(suppl 4):907 (abstract)
Lam SK, Hui WM, Lau WY, Bianicki FJ, Lai CL, Lok ASF, Ng MMT, Fok FJ, Poon GP, Choi TK: Cigarette smoking affects healing and relapse of cimetidine-treated but not sucralfate-treated duodenal ulcer. Gastroenterology 92:1193–1201, 1987
Marks IN, Wright JP, Lucke W, Girdwood AH: Relapse rates after initial ulcer healing with sucralfate and cimetidine. Scand J Gastroenterol 17:429–432, 1982
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Supported by the Peptic Ulcer Research Fund (311/041/0372), and University Grants (311/030/8009/31, 311/030/8010/12, 311/030/8010/69, 335/041/0006) of the University of Hong Kong.
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Hui, WM., Lam, SK., Chau, PY. et al. Persistence ofCampylobacter pyloridis despite healing of duodenal ulcer and improvement of accompanying duodenitis and gastritis. Digest Dis Sci 32, 1255–1260 (1987). https://doi.org/10.1007/BF01296375
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DOI: https://doi.org/10.1007/BF01296375