Precancerous lesions effects on the eradication of Helicobacter pylori

Background and Aims: There is limited data regarding the effect of gastritis severity, the existence of atrophy, and intestinal metaplasia on the Helicobacter pylori eradication. Herein we aimed to investigate the relationship between Helicobacter pylori eradication and histopathological parameters like gastritis severity, intestinal metaplasia and/or atrophy, and the Sydney classification. Material and Methods: Patients diagnosed with Helicobacter pylori gastritis were enrolled in the study between July 2017 and December 2017. All patients received standard quadruple therapy with bismuth salt. Results: In total, 634 patients were enrolled. The success of Helicobacter pylori eradication in the presence of atrophy in the gastric antrum was low, while the eradication success was not affected in the presence of intestinal metaplasia (p=0.025 and p >0.05, respectively). Eradication success was lower in the group with atrophy and intestinal metaplasia in the antrum (p=0.016 and p=0.01, respectively). Eradication failure was higher in the group with severe gastritis (p=0.015 for OLGA III-IV, p=0.032 for OLGIM III-IV). Intestinal metaplasia in the corpus and severity of the lymphoid aggregation were independent risk factors for treatment failure (p=0.002 and p=0.042, respectively). Conclusion: Severity of gastritis, intestinal metaplasia, and gastric atrophy had a negative effect on Helicobacter pylori eradication success. Treatment protocols and duration should be carefully planned in patients with these features