No Bugs Bugging You? Emerging Insights into Helicobacter-Negative Gastritis

Miraca Life Sciences Research Institute, Miraca Life Sciences, Irving, Texas, USA.
The American Journal of Gastroenterology (Impact Factor: 10.76). 01/2013; 108(1):72-4. DOI: 10.1038/ajg.2012.377
Source: PubMed


Depending on how it is defined, between 3 and 20% of patients who have gastric biopsy specimens are diagnosed with "Helicobacter-negative gastritis." In a paper published in this issue of the Journal, data regarding use of tobacco, alcohol, nonsteroidal anti-inflammatory drugs, and proton pump inhibitors were collected from 41 patients with gastritis in whom no Helicobacters were detected by histology and culture and had negative serology. No significant associations with any of the parameters evaluated were found. Further studies are warranted to elucidate this elusive entity. Additional methods (e.g., the urea breath test and polymerase chain reaction) could be used to exclude Helicobacter infection, and a search for other candidate infectious agents (bacteria and Epstein-Barr virus) should be undertaken in those patients found to be unequivocally uninfected with Helicobacter.

11 Reads
  • [Show abstract] [Hide abstract]
    ABSTRACT: The American Journal of Gastroenterology is published by Nature Publishing Group (NPG) on behalf of the American College of Gastroenterology (ACG). Ranked the #1 clinical journal covering gastroenterology and hepatology*, The American Journal of Gastroenterology (AJG) provides practical and professional support for clinicians dealing with the gastroenterological disorders seen most often in patients. Published with practicing clinicians in mind, the journal aims to be easily accessible, organizing its content by topic, both online and in print., *2007 Journal Citation Report (Thomson Reuters, 2008)
    The American Journal of Gastroenterology 07/2013; 108(7):1182-1183. DOI:10.1038/ajg.2013.153 · 10.76 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The decrease in the prevalence of Helicobacter pylori (Hp) infection in children in the world gave rise to a new pathological finding termed as Hp-negative gastritis. Unfortunately, the term “Hp-negative gastritis” has not been identified as a pathological process and has the status of a “second cousin”; in most publications it was never mentioned as a subject to be dealt with, but was “left over” data that was never the topic of the manuscripts’ discussions. Only recently has the topic captured the attention of the pathologists who described this phenomenon in adults, yet the pathological and/or clinical spectrum or significance of this phenomenon has not been adequately investigated. In the current manuscript we describe Hp-negative gastritis in children, summarize its clinical prevalence and touch upon the possible etiology, pathology, and/or therapeutic implication. Overall, this review has concluded that Hp-negative gastritis is a pathological phenomenon in children that needs further investigation, and to date, as the title suggests, is a new clinical enigma that needs to be considered.
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: We aimed to characterize age-related changes in the gastric mucosa and investigate the contribution of Helicobacter pylori infection to these changes. We collected data from a large national pathology database of 895,323 subjects who underwent esophago-gastro-duodenoscopy (EGD) with gastric biopsies from January 2008 through December 2013 at endoscopy centers throughout the US. The prevalence of various types of gastric histopathology was expressed as percent of the total study population, stratified by sex, age, and US state. Over a lifetime, the gastric mucosa became abnormal in 50% of subjects. A higher proportion of people in areas with a high prevalence of H pylori infection acquired gastric abnormalities. H pylori-associated chronic active gastritis and mucosal changes secondary to infection were observed in 22% of biopsies; these were the most common gastric abnormalities observed. Reactive gastropathy, detected in 18% of biopsies, increased with age and was the second most common factor of gastric pathology observed. Based on an analysis of biopsies collected by EGD in the US, gastric abnormalities increase with age. Most pathologies detected by histologic analysis are caused by H pylori infection, but the causes of many others are unknown. Copyright © 2015 AGA Institute. Published by Elsevier Inc. All rights reserved.
    Clinical Gastroenterology and Hepatology 02/2015; DOI:10.1016/j.cgh.2015.02.020 · 7.90 Impact Factor