Abstract
BackgroundThe elderly population presents higher morbidity of H. pylori associated diseases in proximal stomach. The specific pathogenesis and mechanism have not been clearly addressed. The gastric environment for H. pylori colonization is dynamic with increasing age. The aim of present study is to investigate the correlation among the distribution of H. pylori, mucosal inflammation, gastric microenvironment and age.MethodsA total of 180 patients with dyspepsia symptoms were divided into young, middle-aged and elderly groups. Biopsies were obtained from each patient in five locations: great curvature (mid-corpus, mid-antrum), lesser curvature (mid-corpus, mid-antrum) and incisura angularis (IA), analyzed for H. pylori density, mucosal inflammation and histopathology.ResultsThe infection rate of H. pylori increased linearly with age (p < 0.001) in corpus, but not in antrum and IA. The H. pylori density was significantly aggravated in IA (p = 0.002) and corpus (p < 0.001) in elderly patient, but not in antrum. The mucosa inflammation scores were consistent with the severity of H. pylori colonization among three age groups. In elderly patients, the pyloric glands present more frequently in corpus, comparing with young and middle-aged group. A significant positive correlation among aggravating severity of H. pylori infection, mucosal inflammation and pyloric metaplasia in corpus with increasing age (p < 0.001) was occurred.ConclusionsWith increasing age, both topographic distribution of H. pylori and the expansion of pyloric glands increased in a distal-to-proximal gastric direction. Pyloric metaplasia in corpus was correlated with the risk of aggravated H. pylori colonization and associated inflammation in elderly population.
Highlights
The elderly population presents higher morbidity of H. pylori associated diseases in proximal stomach
Data from our research further demonstrated that the aggravations of both H. pylori infection rate and H. pylori colonization severity in corpus was more conspicuous than the antrum and incisura angularis (IA) with
Based on the findings in the present study, it is concluded that both H. pylori distribution and mucosal inflammation present a tendency running to the proximal of stomach with increasing age, which correlated with pyloric metaplasia
Summary
The elderly population presents higher morbidity of H. pylori associated diseases in proximal stomach. There is convincing evidence that the elderly population has a significantly higher mean morbidity of H. pylori associated diseases than young people [11,12,13]. Graham et al have reported that H. pylori infection prevalence increased gradually with age, leveling out at 60–70% in elderly people from less than 20% in 25–30-year-olds [14]. H. pylori associated diseases, such as ulcers and gastric cancer, are more evenly distributed throughout the stomach in the elderly, in proximal stomach [11, 12, 15]. The specific pathogenesis and mechanism of the high prevalence of H. pylori associated diseases in proximal stomach of elderly population have not been clearly addressed
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
