Helicobacter pylori-negative gastritis: Prevalence and risk factors

Helena Nordenstedt, David Y. Graham, Jennifer R. Kramer, Massimo Rugge, Gordana Verstovsek, Stephanie Fitzgerald, Abeer Alsarraj, Yasser Shaib, Maria E. Velez, Neena Susan Abraham, Bhupinderjit Anand, Rhonda Cole, Hashem B. El-Serag

Research output: Contribution to journalArticle

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Abstract

Objectives: Recent studies using histology alone in select patients have suggested that Helicobacter pylori-negative gastritis may be common. The objective of this study was to investigate the prevalence of H. pylori among individuals with histologic gastritis. Methods: Subjects between 40 and 80 years underwent elective esophagogastroduodenoscopy at a VA Medical Center. Gastric biopsies were mapped from seven prespecified sites (two antrum, four corpus, and one cardia) and graded by two gastrointestinal pathologists, using the Updated Sydney System. H. pylori-negative required four criteria: negative triple staining at all seven gastric sites, negative H. pylori culture, negative IgG H. pylori serology, and no previous treatment for H. pylori. Data regarding tobacco smoking, alcohol drinking, nonsteroidal anti-inflammatory drug, and proton pump inhibitor (PPI) use were obtained by questionnaire. Results: Of the 491 individuals enrolled, 40.7% (200) had gastritis of at least grade 2 in at least one biopsy site or grade 1 in at least two sites. Forty-one (20.5%) had H. pylori-negative gastritis; most (30 or 73.2%) had chronic gastritis, five (12.2%) had active gastritis, and six (14.6%) had both. H. pylori-negative gastritis was approximately equally distributed in the antrum, corpus, and both antrum and corpus. Past and current PPI use was more frequent in H. pylori-negative vs. H. pylori-positive gastritis (68.2% and 53.8%; P=0.06). Conclusions: We used multiple methods to define non-H. pylori gastritis and found it in 21% of patients with histologic gastritis. While PPI use is a potential risk factor, the cause or implications of this entity are not known.

Original languageEnglish (US)
Pages (from-to)65-71
Number of pages7
JournalAmerican Journal of Gastroenterology
Volume108
Issue number1
DOIs
StatePublished - Jan 2013
Externally publishedYes

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Gastritis
Helicobacter pylori
Proton Pump Inhibitors
Stomach
Digestive System Endoscopy
Biopsy
Negative Staining
Cardia
Pylorus
Serology
Alcohol Drinking
Histology
Anti-Inflammatory Agents
Immunoglobulin G
Smoking

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Nordenstedt, H., Graham, D. Y., Kramer, J. R., Rugge, M., Verstovsek, G., Fitzgerald, S., ... El-Serag, H. B. (2013). Helicobacter pylori-negative gastritis: Prevalence and risk factors. American Journal of Gastroenterology, 108(1), 65-71. https://doi.org/10.1038/ajg.2012.372

Helicobacter pylori-negative gastritis : Prevalence and risk factors. / Nordenstedt, Helena; Graham, David Y.; Kramer, Jennifer R.; Rugge, Massimo; Verstovsek, Gordana; Fitzgerald, Stephanie; Alsarraj, Abeer; Shaib, Yasser; Velez, Maria E.; Abraham, Neena Susan; Anand, Bhupinderjit; Cole, Rhonda; El-Serag, Hashem B.

In: American Journal of Gastroenterology, Vol. 108, No. 1, 01.2013, p. 65-71.

Research output: Contribution to journalArticle

Nordenstedt, H, Graham, DY, Kramer, JR, Rugge, M, Verstovsek, G, Fitzgerald, S, Alsarraj, A, Shaib, Y, Velez, ME, Abraham, NS, Anand, B, Cole, R & El-Serag, HB 2013, 'Helicobacter pylori-negative gastritis: Prevalence and risk factors', American Journal of Gastroenterology, vol. 108, no. 1, pp. 65-71. https://doi.org/10.1038/ajg.2012.372
Nordenstedt H, Graham DY, Kramer JR, Rugge M, Verstovsek G, Fitzgerald S et al. Helicobacter pylori-negative gastritis: Prevalence and risk factors. American Journal of Gastroenterology. 2013 Jan;108(1):65-71. https://doi.org/10.1038/ajg.2012.372
Nordenstedt, Helena ; Graham, David Y. ; Kramer, Jennifer R. ; Rugge, Massimo ; Verstovsek, Gordana ; Fitzgerald, Stephanie ; Alsarraj, Abeer ; Shaib, Yasser ; Velez, Maria E. ; Abraham, Neena Susan ; Anand, Bhupinderjit ; Cole, Rhonda ; El-Serag, Hashem B. / Helicobacter pylori-negative gastritis : Prevalence and risk factors. In: American Journal of Gastroenterology. 2013 ; Vol. 108, No. 1. pp. 65-71.
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abstract = "Objectives: Recent studies using histology alone in select patients have suggested that Helicobacter pylori-negative gastritis may be common. The objective of this study was to investigate the prevalence of H. pylori among individuals with histologic gastritis. Methods: Subjects between 40 and 80 years underwent elective esophagogastroduodenoscopy at a VA Medical Center. Gastric biopsies were mapped from seven prespecified sites (two antrum, four corpus, and one cardia) and graded by two gastrointestinal pathologists, using the Updated Sydney System. H. pylori-negative required four criteria: negative triple staining at all seven gastric sites, negative H. pylori culture, negative IgG H. pylori serology, and no previous treatment for H. pylori. Data regarding tobacco smoking, alcohol drinking, nonsteroidal anti-inflammatory drug, and proton pump inhibitor (PPI) use were obtained by questionnaire. Results: Of the 491 individuals enrolled, 40.7{\%} (200) had gastritis of at least grade 2 in at least one biopsy site or grade 1 in at least two sites. Forty-one (20.5{\%}) had H. pylori-negative gastritis; most (30 or 73.2{\%}) had chronic gastritis, five (12.2{\%}) had active gastritis, and six (14.6{\%}) had both. H. pylori-negative gastritis was approximately equally distributed in the antrum, corpus, and both antrum and corpus. Past and current PPI use was more frequent in H. pylori-negative vs. H. pylori-positive gastritis (68.2{\%} and 53.8{\%}; P=0.06). Conclusions: We used multiple methods to define non-H. pylori gastritis and found it in 21{\%} of patients with histologic gastritis. While PPI use is a potential risk factor, the cause or implications of this entity are not known.",
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