Impact of quadruple eradication therapy on the elements of the Sydney system in chronic Helicobacter pylori gastritis in Abidjan (Ivory Coast)

Background: The effect of eradicating Helicobacter pylori on the course of chronic gastritis (CG) is controversial. The aim of this study was to assess the impact of H. pylori eradication treatment on CG. Materials and Methods: This was a retrospective (January 2016 to December 2018) multicenter study. All medical records of patients treated with a quadruple therapy to eradicate H. pylori who were confirmed with histology at least 4 weeks after the end of treatment were included. The evolution of the CG ratings after treatment was analyzed. Results: The records of 170 patients (male/female ratio 0.95, average age 49.3 ± 12.2 years) were included. Respectively, inflammation and H. pylori levels decreased (P < 0.001) in antrum (2.09 to 1.45; 1.95 to 0.63) and fundus (1.82 to 1.27; 1.76 to 0.55). Gastric atrophy levels regressed in antrum (0.28 to 0.18; P = 0.0655) and fundus (0.19 to 0.09; P = 0.0096) on sequential quadruple therapy (0.42 to 0.26; P = 0.2384), with bismuth (0.27 to 0.1l8; P = 0.6232) or with concomitant therapy for 14 days (0.20 to 0.13; P = 0.1288). Gastric intestinal metaplasia progressed in the antrum (0.05 to 0.06; P = 0.5930) and the fundus (0.02 to 0.03; P = 0.2568); in sequential quadruple therapy (0.04 to 0.07; P = 0.3173) and in bismuth therapy groups (0.04 to 0.09; P = 0.5637) even after eradication of H. pylori (0.03 to 0.09; P = 0.0455). Conclusions: The eradication treatment for H. pylori improved elements of the Sydney CG system except for intestinal metaplasia.