It has been uncertain what types of erythematous gastric mucosa are produced by Helicobacter pylori (H. pylori)-infection. We therefore design the present study to identify the type of erythematous mucosa associated with H. pylori-infection. A total of 590 consecutive Japanese patients (mean age 58.7 years, 185 men and 405 women) referred to our hospital for diagnostic upper gastrointestinal endoscopy were recruited in this study. We assessed endoscopically the type of gastric mucosal erythema, including spotty erythema, haemorrhagic erosion, reddish streaks, and raised erosion. H. pylori infection was diagnosed by a positive endoscopic 13C-urea breath test (e-UBT). Of the 402 H. pylori-positive subjects, spotty erythemas in the corpus were found in 177 (44.0%), haemorrhagic erosions in 26 (6.5%), reddish streaks in the antrum in 21 (5.2%) and in the corpus in 10 (2.5%), and raised erosions in the antrum in 58 (14.4%) and in the corpus in 4 (1.0%). For spotty erythema in the upper body, sensitivity was 44.0%, specificity was 92.6% for H. pylori infection. Seventy-two (86.7%) of 83 patients with antral reddish streaks and 65 (52.8%) of 123 patients with antral raised erosions had H. pylori-negative e-UBT. Spotty erythema in the corpus was one of most frequent endoscopic findings reflecting H. pylori infection. In contrast, antral reddish streaks and raised erosions were likely to indicate the absence of H. pylori.
Helicobacter pylori; spotty erythema; haemorrhagic erosion; reddish streaks; raised erosion