Chronic Alcoholic Gastritis

Abstract

We assessed the relative roles of alcohol and infection with<i>Helicobacter pylori</i>in the pathogenesis of chronic gastritis in alcoholic patients.<i>Helicobacter pylori</i>was found in 14 of 18 alcoholics with dyspepsia and was associated with chronic antral gastritis. Gastric biopsy specimens were normal in four<i>H pylori</i>—negative alcoholics. Studies were repeated 3 to 4 weeks after controlled abstinence. There was no change in histologic findings during this period, indicating that alcohol itself was not the major causative agent. We then eliminated<i>H pylori</i>in 10 subjects by giving triple therapy (bismuth subsalicylate, amoxicillin, and metronidazole). Treatment for<i>H pylori</i>was associated with almost complete normalization of histologic findings. Four control subjects who received antacids alone showed no improvement. Dyspeptic symptoms in<i>H pylori</i>—positive patients significantly improved after elimination of this organism, whereas there was no change with antacid treatment. (<i>Arch Intern Med</i>. 1991;151:760-764)