Chronic active gastritis after eradication of Campylobacter (now: Helicobacter) pylori. Results of a medium term follow-up study.

11 patients with C.p.-associated chronic gastritis underwent a triple therapy with bismuth-subsalicylate, amoxicillin susp. and metronidazole. The C.p.-status and the inflammation parameters "polymorphonuclear leucocytes in the epithelium". "polymorphonuclear leucocytes in the lamina propria", "lympho-plasmacellular infiltrate in the lamina propria", "congestion and edema of the lamina propria" and "inflammatory alteration of the epithelium" were determined semi-quantitatively in semi-thin-sections by light microscopy in the same sections. The C.p.-status was verified further by means of the CLO-test and cultures. The biopsy probes were taken before treatment, immediately after treatment, 1 month following treatment and in differing time intervals up to 9 months following treatment. Eradication of C.p. could not be attained in 2 of the patients. Spherical forms and vibrioforms of C.p. exhibiting degenerative alterations could be demonstrated by electron microscopy. Throughout the study the inflammatory parameters "intraepithelial polymorphonuclear leucocytes", "polymorphonuclear leucocytes in the lamina propria", "inflammatory alterations of the epithelium" showed concordance in their reactions. They were closely correlated with the light microscopical demonstration of C.p.-organisms in the biopsy specimens. The regression of the lympho-plasmacellular infiltrate was still incomplete after 5 months of eradication. The time relationship between the end of treatment and complete remission differed. The results of our studies suggest that C.p. was the sole etiological factor for the development of chronic active gastritis in at least 4 of the 11 patients.