Pathogenetic role of Campylobacter pyloridis in gastric ulcer

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Abstract
Recent reports of the occurrence of Campylobacter pyloridis in the stomach of patients with gastric ulcer have revived interest in the possible aetiological role of bacteria in this condition. To study the pathogenetic role of C. pyloridis in gastric ulcer, endoscopic biopsies, at least four from antrum, four from fundus and four, where appropriate, from the ulcer site, were taken from 28 non‐ulcer controls and 67 patients with gastric ulcer before and after complete healing of ulcer, following treatment with either enprostil or cimetidine for up to 8 weeks. The activity of gastritis as assessed by the degree of polymorph infiltration was graded blindly, by two independent pathologists, as nil, mild, moderate or severe. The presence of C. pyloridis was determined by smear and culture, and by Warthin Starry stain, and the bacterial density after staining was scored. The occurrence of C. pyloridis in the gastric antrum was not significantly different in gastric ulcer than in controls but was significantly (P < 0.005) more frequent in gastritic than in non‐gastritic mucosa. With gastric ulcer healing the activity of antral gastritis improved significantly (P < 0.05). Despite ulcer healing and improvement of gastritis, the frequency of occurrence and the density of C. pyloridis remained unchanged. It seems that C. pyloridis occurs frequently in gastritic mucosa, and does not affect the healing of gastric ulcer or improvement of gastritis, suggesting that it is unlikely to play a major pathogenetic role.