Korean J Pediatr Gastroenterol Nutr.
2001 Apr;4(1):18-27.
Evaluation of Endoscopic and Histological Change of Gastritis Related to Helicobacter pylori Eradication in Children
- Affiliations
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- 1Department of Pediatrics , Seoul National University College of Medicine, Seoul, Korea.
- 2Department of Pathology, Seoul National University College of Medicine, Seoul, Korea.
Abstract
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PURPOSE: The aims of this study are to investigate the effect of the eradication of H. pylori on
histological change of gastric mucosa in children with H. pylori gastritis and to determine whether
the histological grading by the Sydney system is valuable in predicting the effect of treatment.
METHODS
1) Histological scores by the Sydney system and the endoscopic characteristics were
assessed before and at least four weeks after anti-H. pylori therapy in 42 children with H. pylori
gastritis. 2) In 32 children treated with omeprazole, amoxicillin and clarithromycin (OAC), pretreatment
histological scores and endoscopic findings were compared between the eradicated and the
noneradicated to evaluate their predictive value for the successful eradication.
RESULTS
1) In the eradicated (27 cases), nodular gastritis significantly decreased from 89% to 63%
(p<0.05). There was an significant improvement in the mean activity score from 2.06 before
treatment to 0.24 after treatment (p<0.01). The mean inflammatory score also improved from 2.61
before treatment to 1.89 after treatment (p<0.05). Lymphoid follicles significantly decreased from
48% to 15% (p<0.05). Epithelial damage improved in all 4 cases. But in the noneradicated (15
cases), there was no significant change in the frequency of nodular gastritis, the mean activity score,
the mean inflammatory score and the frequency of the lymphoid follicles. 2) In 32 children treated
with OAC, there was a tendency that the higher was the pretreatment score of the bacterial density,
the lower was the eradication rate of H. pylori (p=0.072).
CONCLUSION
The loss of the polymorphonuclear cell infiltration is the most prominent histological
change after successful eradication. There may be negative correlation of the grade of the bacterial
density with the success rate of the anti-H. pylori therapy.