Antral gastritis

Because of its antibacterial activity against microorganisms [51-54] and the lack of strains with primary resistance [52, 53], some preliminary studies [174-176] have explored the potential of rifaximin for II. pylori eradication. A first single-blind randomized study [174] evaluated the efficacy of rifaximin alone or in combination in II. pylori-positive patients with antral gastritis and... 

Helicobacter pylori H. pylori is found in approximately 100% of chronic active antral gastritis cases, 90% to 95% of duodenal ulcer patients, and 50% to 80% of gastric ulcer patients. The treatment of documented H. pylori infection in patients with confirmed peptic ulcer on first presentation or recurrence has been recommended by the National Institutes for Health in a 1994 Consensus Conference. Once H. py/on eradication has been achieved, reinfection rates are less than 0.5% per year, and ulcer recurrence rates are dramatically reduced. 

H. pylori infection is well known as the causative agent of antral gastritis and peptic ulcer disease (see Sect. 3.4.2). On barium studies, the most frequent finding will be (markedly) thickened gastric folds, or even thickened and lobulated gastric folds can be seen. 

Rauws EAJ, Langenberg W, HouthofFH J et al (1988) Campylobacterpyloridis associated chronic active antral gastritis a prospective study of its prevalence and the effects of antibacterial and antiulcer treatment. Gastroenterology 94 33-40... 

Unge P, Gad A, Gnarpe H et al (1989) Does omeprazole improve antimicrobial therapy directed towards gastric Campylobacter pylori in patients with antral gastritis A pilot study. Scand J Gastroenterol 24 (Suppl 167) 49-54... 

Fig. 3.21 a,b. Chronic antral gastritis with several rows of erosions converging towards the pylorus (a), also shown on the double-contrast barium meal (b)... 

Am J Roentgenol Radium Ther Nucl Med 101(2) 425-430 Davies PM (1978) Smooth muscle tumours of the upper gastrointestinal tract. Clin Radiol 29(4) 407-414 Dheer S, Levine MS et al (2002) Radiographically diagnosed antral gastritis findings in patients with and without... 

Antral or prepyloric ulcers and erosive gastritis were identified after 12 of 84 courses of interleukin-4 in 72 patients, of whom three suffered from life-threatening bleeding. There were no treatment-related deaths and no clear correlation with the dose of interleukin-4. A possible protective effect of interleukin-2 on the... 

Erythromycin is a motilin receptor agonist (2-4). Azithromycin also produced a significant increase in postprandial antral motility (5). Clarithromycin is also prokinetic, as shown in 16 patients with functional dyspepsia and Helicobacter pylori gastritis (6). For this reason, the macrolides have been used to treat gastroparesis (7). 

In cases of suspected autoimmune gastritis, gastrin immunohistochemistry can be used to distinguish antral from atrophic body or fundic mucosa synaptophysin and chromogranin immunohistochemistry is useful in the detection of enterochromaffin-like cell hyperplasia, a characteristic feature of autoimmune gastritis. 

Changes in Helicobacter density are paralleled by changes of the severity of gastritis. Gastritis improves in the antrum and worsens in the corpus and fundus [12, 21]. This fact has practical implications when attempting to diagnose H. pylori infection by endoscopic biopsies, both antral and corpus biopsies must be studied, particularly when PPIs are taken, in order to prevent false negative results [27-30]. 

In gastric ulcer (GU), the topographic expression of chronic gastritis is such that the body mucosa and antral mucosa are equally affected. Unlike DU, acid secretion is decreased in patients with GU, because of the more severe involvement of the body mucosa. Acid-inhibitory drugs, in particular PPIs always lead to changes in the pattern of gastritis, with a reduction of bacteria and inflammatory activity in the antrum and an increase of both these conditions in the body [15-17]. 

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