Perspectivas en la gastritis crónica

Three types of chronic gastritis (with the exception of forms with specific ethiology) are recognized at the present: immune gastritis, type A, associated with pernicious anemia; infectious gastritis, typeB, associated with H. pylori; and chemical gastritis, associated with duodenal reflux or with aspirin or non-steroidal anti-inflammatory drugs. H. pylory infection ic now accepted by far as the major cause of gastritis and peptic ulcers.To study the relationship between histological changes and H. pylori infection, biopsies taken from 1,000 patients were examined. Four histological parameters were taken into account: inflammation of the lamina propria; activity, defined as the presence of granulocytes within or in close contact with the epithelium of at least two crypts; epithelial abnormalities; and presence of intestinal metaplasia. Three kinds of epithelial lesions were observed: vacuolation of the luminai part of the cytoplasm, formation of micropapillae and erosion of the luminal part of the cell. H. pylori was detected with Giemsa stain.The activity was correlated with H. pylori (p u003c 0.0001). Epithelial damage correlated with H. pylori (p u003c 0.0001) and with activity (p u003c 0.0001). Intestinal metaplasia was found more often in antrum (18%) than in Corpus (5%). it is found more often in mucosae harboring H. pylori than in H. pylori negative patients. It must be taken in account that H. pylori disappears when the intestinal metaplasia develop and the gastric pH raises.