In the present study we evaluated the relation among histology, H. pylori,
IgG to H. pylori, gastric emptying, and
acid secretion in 43 patients with fundic
atrophic gastritis. On the basis of gastric acid secretion, patients were divided into three subgroups: patients with preserved
acid secretion (Group 1), patients with
hypochlorhydria (Group 2), and patients with
achlorhydria (Group 3). Fundic glandular
atrophy was more severe in hypoachlorhydric patients than in those with preserved
acid secretion (P < 0.05 vs Group 2, P < 0.005 vs Group 3). H. pylori colonization was found in 94% of patients in Group 1, in 61% of patients in Group 2, and in only 8% of patients in Group 3 (P < 0.001 vs Group 1, P < 0.05 vs Group 2). Conversely, serological positivity to H. pylori was high in all three subgroups of patients (100% in Group 1, 77% in Group 2, 92% in Group 3). Gastric emptying was delayed in atrophic patients, particularly in those with hypoachlorhydria. Our data suggest that fundic
atrophic gastritis represents a possible end stage of H. pylori
infection, characterized by a progressive disappearance of the bacterium and a progressive deterioration of gastric functions.