Effect of helicobacter pylori density on inflammatory activity in stomach

Aim: To assess the relationship of H. pylori density on inflammatory activity in different parts of stomach. Materials and Methods: Endoscopic biopsies were taken from gastric antrum, corpus and cardia of 150 dyspeptic patients in a prospective analysis. A semiquantitative scoring was done according to updated Sydney system in accordance with the variables like H. pylori density, neutrophil activity and mononuclear cell infiltrate. Glandular atrophy and intestinal metaplasia was also noted. Statistical analysis was done using Spearman rank correlation test. Result: One hundred and fifty patients, 94 males and 56 females (with a mean age of 35.4) were analyzed. Morphologically within stomach 82.7% of antral, 74% of corpus and 68% of cardia biopsies were positive for H. pylori. Correlation coefficient of H. pylori density and neutrophil activity was 0.542, 0.644 and 0.729 for antrum, corpus and cardia respectively (P=0.00); while the correlation coefficient of mononuclear cell infiltrate with H. pylori density was 0.173, 0.245 and 0.326 for antrum, corpus and cardia respectively (P=0.035, 0.003, 0.000). H. Pylori density in corpus and cardia was proportional to its density in antrum. Conclusion: Density of H. pylori is more in the antrum due to its alkaline pH and the neutrophil activity shows a direct association with H. pylori density.