Highfrequency ofhelicobacter negative gastritis inpatients withCrohn's disease

Thefrequency ofgastric Crohn's disease hasbeenconsidered low.Thisstudywas undertaken todetermine theprevalence of chronic gastritis andHelicobacter pylori infection inpatients withCrohn's disease. Oesophagogastroduodenoscopy was performedon62consecutive patients sufferingfromileocolonic Crohn'sdisease. Biopsyspecimens fromtheantrumand corpus wereprocessed forbothhistological andbacteriological examinations. Hpylori antibodies ofIgGandIgAclasses were measuredinserumsamplesbyenzyme immunoassay. Sixpatients (9.70/o) were infected withH pylorn, asshownbyhistology,andinfiveofthemtheinfection wasalsoverified byserology. Twentyone patients (32%)had chronicH pyloni negativegastritis (negative by both histology andserology) andoneofthem also hadatrophy intheantrumandcorpus. Granulomas werefoundinfourpatients. Thecharacteristic appearance ofH pylori negative gastritis was focalandmostly mildinflammation resembling theinflammatorychanges seeninthegutinCrohn's disease. Patients withH pylori negative chronic gastritis hadasignificantly more active disease intheir gutthanthosewith normalgastric mucosa (p<0-01). Itis concluded thatH pylori positive gastritis israre,whileH pylori negative gastritis isrelatively common inpatients with Crohn'sdisease. H pylorinegative 'Crohn's gastritis' seemstobeassociated withactive Crohn's disease. (Gut1996; 38:379-383) FourthDepartment of Surgery, Helsinki University Hospital, FinlandHalme