Endoscopic diagnosis of gastritis in relation to Helicobacter pylori infection and subjective symptoms

The relationship between endoscopic findings associated with gastritis, Helicobacter pylori infection, and subjective symptoms was investigated to establish methods for a simple endoscopic diagnosis of gastritis. The subjects comprised 102 patients who had no localized lesions in the upper gastrointestinal tract. The proportion of anti-H. pylori IgG antibody (GAP IgG)-positive cases was 67% and that of culture-positive cases was 47%. The results of the present investigation showed that the histologic diagnosis of gastritis according to the Sydney System was definitely correlated with H. pylori infection as determined by both culture and serologic techniques. The endoscopic findings were categorized as either atropic changes (discoloration and/or transparency of vessels) or erosive changes (erosion). H. pylori infection was found to be related to atropic changes, whereas subjective symptoms correlated well with erosive changes. The results demonstrated the utility of categorizing endoscopic findings related to gastritis as either atropic changes, which are closely related to H. pylori infection, or erosive changes, the main cause of subjective symptoms.