[The particularity of Helicobacter pylori chronic gastritis in the west center of Tunisia].

Background: The Helicobacter pylori (HP) is strongly associated with chronic gastritis. The aim of our study was to determine prevalence of the HP chronic gastritis in the west center of Tunisia and to clarify the clinical and the histological particularities of this infection.

Methods: it is a prospectif study carried out from September 2002 to July 2005 and had included 352 patients. All the patients had an upper endoscopy in which five gastric biopsies were taken for a histological study. The biopsy specimens were fixed in 10% buffered formol and then included in paraffin. The specimens were cut at 4 microm and stained with Hematoxyline Eosine, modified Giemsa and Alcian bleu SAP. The histological examination revealed HP specimens, the lymphoplasmocytic infiltration, the gastritis activity, the gastric atrophy and the intestinal metaplasia according to Sydney system.

Results: They were 162 men and 190 women,with a mean age of 48.3 years. The erythematous antral gastritis was the most frequent at endoscopy (26.7%). The prevalence of HP chronic gastritis was 89% in patients with endoscopic lesions. The activity of the gastritis was 89.7% in the antrum and 52.2% in the fundus. The activity mean score in the antrum was 2, 1.8 and 0.3 respectively in the case of duodenal ulcer and gastric adenocarcinoma vs 0.68, 1.1 and 0.16 in gastric fundus. The prevalence of gastric atrophy was 35%. The atrophy was found in the antrum in 98% of cases. The prevalence of intestinal metaplasic was 11%.

Conclusion: the HP chronic gastritis is very frequent in the west center of Tunisia. Its prevalence is found elevated since the adolescence. It predominate the gastric antrum. It is often associated with a duodenal ulcer rather than gastric cancer.