High Incidence of Campylobacter-Like Organisms in Endoscopic Biopsies from Patients with Gastritis, with or without Peptic Ulcer

Abstract

Campylobacter-like organisms (CLOs) were histologically detected in 230 (74.5%) of 310 patients undergoing endoscopy with multiple gastric biopsies for symptoms suggestive of upper digestive disease. CLOs were found in 78.6% of nonulcerous dyspeptic patients, 82.2% of healed ulcers, 88.2% of duodenal or pyloric ulcers and 90.0% of gastric ulcers but only in 46.9% of gastric stumps and 47.6% of nonulcerous patients without dyspepsia. Among 274 subjects with gastritis, CLOs were found in 83.9%, while none of the 36 gastritis-free stomachs harbored CLOs. Severe atrophic gastritis was less frequently infected with CLO (55.5%) as compared with superficial, interstitial or preatrophic gastritis (84.4%). CLOs were only slightly more frequent in the presence of intraepithelial granulocytes and were never found in areas of complete intestinal metaplasia. Foveolar and superficial epi-thelia heavily infected with CLOs showed peculiar ultrastructural changes (micropapillary hyperplasia with luminal bulging of mucous cells, cytoplasmic vacuolization and edema, etc.) suggesting a direct link between CLO infection and epithelial damage, which in turn may have a role in the genesis of mucosal inflammation.