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Helicobacter pylori colonisation of duodenal foveolar metaplasia requires concurrent gastric infection
  1. Adam L Booth1,
  2. Raul S Gonzalez2
  1. 1 Pathology, University of Texas Medical Branch at Galveston, Galveston, Texas, USA
  2. 2 Pathology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
  1. Correspondence to Dr Adam L Booth, University of Texas Medical Branch at Galveston, Galveston, Texas, USA; ALBoothMD{at}


Aims Evaluate the rate and significance of Helicobacter pylori (H. pylori) involving duodenal foveolar metaplasia of chronic peptic duodenitis (CPD).

Methods We identified 100 biopsy cases of CPD with synchronous stomach biopsies. All 200 were reviewed for histological changes (eg, chronic gastritis, acute inflammation) and underwent immunohistochemical staining for H. pylori. Results were correlated with patient age, sex, endoscopy indication and findings on stomach biopsy.

Results Cases included 49 men and 51 women, with a median age of 56 years. Reflux or dysphagia was the most common symptom. Chronic gastritis was present in 46 stomach biopsies, with 54 within normal limits. Twelve stomach biopsies showed H. pylori, all of which showed gastritis. Two duodenal biopsies (2%) demonstrated H. pylori organisms on immunohistochemistry, both from patients with H. pylori gastritis.

Conclusions Routine examination of CPD samples for H. pylori appears unnecessary if a stomach biopsy is available for review.

  • gastritis
  • gastrointestinal diseases
  • intestine
  • small
  • immunohistochemistry
  • helicobacter

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  • Handling editor Tony Mazzulli.

  • Twitter @ALBoothMD, @RaulSGonzalezMD

  • Contributors ALB analysed data and wrote the manuscript. RSG designed the research study, analysed data and reviewed pathological tissue.

  • Funding Funding was provided by RSG’s institutional startup fund.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.