ENDOSCOPIC FEATURES OF HELICOBACTER PYLORI-INFECTED GASTRITIS

Objective It would be desirable to diagnose H. pylori-related gastritis simply by endoscopic observation. However, it remains controversial whether certain endoscopic features can be used to diagnose H. pylori infection. Material & Methods A new modified endoscopic 13C-urea breath test (Dig Endosc 12:29-32,2000) was performed in 628 patients. Briefly, after endoscopic observation, 20ml of water containing 100mg of 13 (urea is sprayed onto the gastric mucosa. Thereafter, a sample of 150mlof intragastric gas is collected through a biopsy channel. A positive test was defined as an increase in the ratio of 10 per mil over baseline. Endoscopic features were evaluated by the presence of following findings; linear reddness, raised erosion, haemorrhagic erosion, haemorrhagic erosion, and spotty erythema. Results The sensitivity, specificity, positive predicts value (PPV), and negative predict value (NPV) of each feature is shown in the following table:     sensitivity specificity PPV NPV spotty erythema (body)   35.9% 89.6% 83.6% 48.7% haemorrhagic   7.6% 86.5% 45.2% 38.8% linear reddness (antrum) 2.7% 69.3% 11.5% 32.6%   (body) 2.4% 95.2% 42.9% 39.8% raised erosion (antrum) 14.1% 73.3% 43.7% 36.7%   (body) 1.1% 99.6% 80.0% 40.6% Conclusion Spotty erythema in the gastric body was thought to reflect H. pylori infection. In contrast, it was suggested that linear reddness in the antrum indicated the absence of H. pylori.