Point prevalence of peptic ulcer and gastric histology in healthy Indians with Helicobacter pylori infection.

OBJECTIVES: To study the prevalence of peptic ulcer and the histological appearance of the gastric mucosa in healthy, asymptomatic Indians infected with Helicobacter pylori.

METHODS: Asymptomatic, healthy individuals without any GI symptoms were invited to undergo endoscopy of the upper GI tract. A careful search was made for any erosion or ulcer. Four biopsy specimens were obtained from the gastric corpus and antrum. Histological sections were stained with hematoxylin and eosin for histological details and with Loffler's methylene blue for the presence of H. pylori. Alcian blue periodic acid-Schiff stain (pH 2.5) was used to classify and grade areas of intestinal metaplasia.

RESULTS: Histological examination showed chronic gastritis in 72 (80%) persons. Pangastritis was seen in 22% of subjects; pangastritis with antral predominance, in 28%; and antrum-only gastritis, in 50%. Activity was noted in biopsy specimens from only 33% of the subjects. H. pylori infection was present in 70 (78%) subjects. All of these subjects had evidence of chronic gastritis. Endoscopic examination revealed a normal appearance in 88 individuals. In two individuals a duodenal ulcer was seen. Both subjects had severe H. pylori infection in the antral mucosa. Of the 70 persons having H. pylori infection, only two (2.8%) had a duodenal ulcer.

CONCLUSIONS: This study showed that despite a high prevalence of H. pylori infection in asymptomatic, healthy Indians, the point prevalence of peptic ulcer is low, and chronic active gastritis is uncommon.