Helicobacter pylori - More than half of world's population is affected, including you and me probably!!!

Helicobacter pylori

Helicobacter pylori causes the following:

1. Gastritis

2. Gastric ulcers

3. MALToma

4. Gastric carcinoma.

How do we identify H.pylori gastritis?

Many of us would have been taught to look for H.pylori organisms in a gastric biopsy with neutrophils (foveolitis/ foveolar abscess/ lamina propria infiltrates).

This is true!!!..

However, H.pylori is the most common type of CHRONIC GASTRITIS.

Presence of neutrophils only signifies active inflammation and likely presence of organisms in the biopsy.

Signs of H.pylori gastritis:

• Loss of mucin in the surface epithelium and epithelial damage leading to irregularity of the surface.
• Chronic inflammation in the lamina propria with lymphoid aggregates and plasma cells.

How do they look?

H.pylori are 2-4um curved structures.

Where to find them?

• Surface mucin
• Adherent to surface foveolar cells
• Within the foveolar pits

In figure, green circles - indicate plasma cells.
Curved organisms seen within the red circles - Helicobacter pylori.


Differential diagnosis for H.pylori:
Helicobacter heilmannii - twice as long as H.pylori and has 5-7 spirals.