High-protein diet suppresses corpus atrophic gastritis in Helicobacter pylori infected Mongolian gerbils.

To investigate the effect of a high-protein diet on corpus atrophic gastritis in Helicobacter pylori-infected Mongolian gerbils, H. pylori was administered orally to 5-wk-old Mongolian gerbils; and the animals were then fed a control diet (Group C); a high-fat diet (Group F: 40% fat); a high-protein diet (Group P: 32% protein); or a high-fat, high-protein diet (Group FP: 40% fat, 32% protein) for 50 wk beginning at 7 wk of age. In uninfected animals, the mucosal thickness of the corpus was significantly greater in Group P and Group FP than in Group C (P < 0.05). In infected animals, the serum gastrin level was significantly decreased in Group FP and marginally significantly decreased in Group P (P = 0.057) in comparison to Group C. The mucosal thickness of the corpus was significantly greater in Group P and Group FP than in Group C (P < 0.05). Mean inflammation and atrophy scores in the corpus were significantly lower in the high-protein groups (Groups P and FP) than in the control groups (Groups C and F; both inflammation and atrophy: P < 0.05). In conclusion, long-term administration of a high-protein diet suppresses corpus atrophic gastritis in H. pylori-infected Mongolian gerbils.

Endoscopic characteristics and Helicobacter pylori infection in NSAID-associated gastric ulcer.

BACKGROUND AND AIM: Helicobacter pylori infection and non-steroidal anti-inflammatory drugs (NSAIDs) are deeply involved in the etiology of gastric ulcers. The aim of our study was to clarify the endoscopic characteristics and H. pylori infection status of NSAID-associated gastric ulcers. METHODS: The study group comprised 50 patients (23 men, 27 women; mean age 66.5 years) with NSAID-associated gastric ulcers and 100 sex- and age-matched patients with gastric ulcer associated with other factors (control group). Ulcer morphology, size and number of lesions, onset site and incidence of hemorrhagic ulcers were investigated endoscopically in both groups. H. pylori infection was diagnosed by serology, histology and (13)C-urea breath test. RESULTS: Multiple lesions (68% vs 20%, P<0.001), occurrence in the antrum (56% vs 6%, P<0.001), and hemorrhagic ulcer (34% vs 4%, P<0.001) were significantly more prevalent in patients with NSAID-associated gastric ulcers than in patients with non-NSAID-associated gastric ulcer. The H. pylori infection rate was significantly lower in NSAID-associated gastric ulcer patients than in non-NSAID-associated gastric ulcer patients (48% vs 96%, P<0.001). In the NSAID-associated gastric ulcer group, the prevalence of H. pylori infection was significantly lower in patients with ulcers in the antrum than in those with ulcers in the angulus or corpus (25% vs 77.3%, P<0.001). CONCLUSIONS: In contrast to non-NSAID-associated gastric ulcers, NSAID-associated gastric ulcers frequently occur in the antrum with bleeding. The rate of H. pylori infection in NSAID-associated gastric ulcers is significantly lower than that in non-NSAID-associated gastric ulcers.

Evaluation of an ELISA for detection of anti-parietal cell antibody.

BACKGROUND/AIMS: Anti-parietal cell antibody (APCA) is used for diagnosis of pernicious anemia and type A gastritis. APCA is present in patients with Helicobacter pylori (H. pylori)-positive gastritis and is related to atrophic gastritis and gastric carcinoma. The aim of the study was to determine whether an enzyme-linked immunosorbent assay (ELISA) can be used to detect APCA. METHODOLOGY: Study subjects were 134 patients (74 men, 60 women; mean age, 63 years; range, 18-88 years) with gastric carcinoma, gastric ulcer, duodenal ulcer, gastritis, type A gastritis or pernicious anemia and H. pylori-negative normal mucosa subjects in the stomach. APCA was measured in all subjects by our ELISA method. Results of ELISA were compared with results of indirect immunofluorescence (IIF). RESULTS: The percentage of samples that were APCA-positives by IIF at a 1/20 or greater serum dilutions was similar to that by ELISA (86.9%). Agreement between ELISA and IIF for presence of APCA was 78.3% in patients with gastric carcinoma, 80.1% (gastric ulcer), 59.1% (duodenal ulcer), 51.7% (gastritis), 75.0% (type A gastritis), 100% (pernicious anemia) and 80.0% (normal). CONCLUSIONS: ELISA is a useful method for detection of APCA for diagnosis of PA and type A gastritis.

Evaluation of endoscopic and histological findings in Helicobacter pylori-positive Japanese young adults.

BACKGROUND AND AIM: Many studies have shown that Helicobacter pylori infection is associated with chronic gastritis, peptic ulcers and gastric carcinoma in adults. However, little is known about these associations in the younger population. The aim of this study was to clarify endoscopic and histological findings in H. pylori-positive young adults. METHODS: Two hundred consecutive outpatients younger than 29 years old undergoing esophago-gastroduodenal endoscopy at four hospitals between 2001 and 2002 were eligible for this study. At endoscopy, three biopsy specimens were obtained from the mid-antrum, the angulus and the mid-corpus. Endoscopic and histological interpretations were based on the updated Sydney System. H. pylori infection was determined by histology and serology. RESULTS: The rates of H. pylori infection were 1.2% (1/86) in normal, 95.8% (46/48) in gastritis, 97.8% (45/46) in duodenal ulcers, 100% (17/17) in gastric ulcers, and 100% (3/3) in gastric carcinomas. Endoscopic findings in 112 H. pylori-positive patients were 25 normal (22.3%), 38 atrophy (33.9%), 18 erosion (16.1%), and 31 nodularity (27.7%). Histological findings of H. pylori-positive patients in the anturm revealed mononuclear cell and neutrophil infiltration in 100%, and atrophy in 27.7%. Histological findings of H. pylori-positive patients in the corpus revealed mononuclear cell infiltration in 75%, neutrophil infiltration in 60.7%, and atrophy in 28.6%. CONCLUSIONS: The study shows that H. pylori infection is strongly associated with chronic gastritis and peptic ulcers, and that histological corpus gastritis was found with high frequency in Japanese young adults.

[Pathophysiology of Barrett's esophagus--motility disorder of esophagus].

Barrett's esophagus is a premalignant condition of reflux esophagitis and the prevalence is increasing in western countries. Although pathogenesis of Barrett's esophagus is still unknown, several studies have indicated that Barrett's esophagus is related to increased acid reflux through decreased lower esophageal sphincter tone and reduced esophageal contractions. In this article recent studies of Barrett's esophagus on pathophysiology of esophageal motility is reviewed.