The Role of Campylobacter pylori in Gastro-Duodenal Disease

  • Pelayo Correa
  • Nubia Muñoz
  • Carlos Cuello
  • James Fox
  • Diego Zavala
  • Bernardo Ruiz


Since 1983 when Warren reported spiral bacteria in 50 percent of gastric biopsies, and the successful culture by Marshall,1 Campylobacter pylori (C.p.), as the “Warren bacteria” was named, has surged to the forefront of gastroenterology and gastrointestinal pathology. Considerable clinical, bacteriologic, and immunologic research is being carried out. Some pathologists and gastroenterologists have reached apparently opposite conclusions concerning its role in human disease: It is considered to be either a common saprophyte or a common pathogenic bacteria, depending on which school of thought interprets the available data. The following review tries to document the association between C.p. and gastritis and to put into perspective the evidence concerning its role in gastrointestinal disease, based on the medical literature and gastrointestinal pathology material from New Orleans, Colombia, and China.


Gastric Mucosa Duodenal Ulcer Chronic Gastritis Superficial Gastritis Antral Gastritis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Warren JR, Marshall B: Unidentified curved bacilli on gastric epithelium in active chronic gastritis. Lancet 1:1273–1275, 1983Google Scholar
  2. 2.
    Morris A, Nicholson G, Anzymlt GL, et al: Seroepidemiology of Campylobacter pyloridis. NZ Med J 99:657–659, 1986Google Scholar
  3. 3.
    Perez-Perez GI, Dworkin BM, Chodos JE, Blaser MJ: Campylobacter pylori antibodies in humans. Ann Intern Med 109:11–17, 1988PubMedCrossRefGoogle Scholar
  4. 4.
    Marshall JB, Armstrong JA, McGechie B, Glancy JR: Attempt to fulfill Koch’s postulates for pyloric Campylobacter. Med J Aust 142:436–439, 1985PubMedGoogle Scholar
  5. 5.
    Morris A, Nicholson G: Ingestion of Campylobacter pyloridis causes gastritis and raised fasting gastric pH. Am J Gastroenterol 82:192–199, 1987PubMedGoogle Scholar
  6. 6.
    Wiersinga WM, Tytgat GN: Clinical recovery owing to parietal cell failure in a patient with Zöllinger-Ellison syndrome. Gastroenterology 73:1413–1417, 1977PubMedGoogle Scholar
  7. 7.
    Ramsey EJ, Carey KV, Peterson WL, et al: Epidemic gastritis with hypochlorhydia. Gastroenterology 70:1449–1457, 1979Google Scholar
  8. 8.
    Hutchinson DN, Bolton FJ, Hinchliffe PM, Holt AV: Distribution in various clinical groups of antibody to Campylobacter pyloridis detected by ELISA, complement fixation and microagglutination tests. Campylobacter III. Proceedings of the Third International Workshop on Campylobacter Infections. London, Public Health Laboratory System, 1985, 185Google Scholar
  9. 9.
    Drumm B, O’Brien A, Cutz E, Sherman P: Campylobacter pyloridis are associated with primary antral gastritis in the pediatric population. Gastroenterology 90:1938, 1986Google Scholar
  10. 10.
    Drumm B, Sherman P, Cutz E, Karmali M: Association of Campylobacter pylori on the gastric mucosa with antral gastritis in children. N Engl J Med 316:1557–1561, 1987PubMedCrossRefGoogle Scholar
  11. 11.
    Mitchell HM, Bohane TD, Berkowicz J, et al: Antibody to Campylobacter pylori in families of index children with gastrointestinal illness due to C. pylori. Lancet 2:681–682, 1987PubMedCrossRefGoogle Scholar
  12. 12.
    Dooley CP, Fitzgibbons P, Cohen H, et al: Prevalence and distribution of Campylobacter pylori in an asymptomatic population. Gastroenterology 94:A102, 1988Google Scholar
  13. 13.
    Berkowitz J, Lee A: Person to person transmission of Campylobacter pylori. Lancet 2:680–681, 1987CrossRefGoogle Scholar
  14. 14.
    Lee A. Hazell S: Campylobacter pylori in health and disease: An ecological perspective. Microbiol Ecol Health Dis 1:1–16, 1988CrossRefGoogle Scholar
  15. 15.
    Rathbone BJ, Wyatt JJ, Worsley BW, et al: Systemic and local antibody response to gastric Campylobacter pyloridis in non-ulcer dyspepsia. Gut 27:642–647, 1986PubMedCrossRefGoogle Scholar
  16. 16.
    Jones DM, Lessells AM, Eldridge J: Campylobacter-like organisms in the gastric mucosa: Culture, histologic and serologic studies. J Clin Path 37:1002–1006, 1984PubMedCrossRefGoogle Scholar
  17. 17.
    Booth L, Holdstock G, MacBride H, et al: Clinical importance of Campylobacter pyloridis and associated serum IgA and IgG antibody responses in patients undergoing upper gastrointestinal endoscopy. J Clin Path 39:215–219, 1986PubMedCrossRefGoogle Scholar
  18. 18.
    Blaser MJ: Gastric Campylobacter-like, organisms, gastritis, and peptic ulcer disease. Gastroenterology 93:371–383, 1987PubMedGoogle Scholar
  19. 19.
    Fox J, Correa P, Taylor N, et al: Campylobacter pylori associated gastritis and immune response in population at high risk of gastric carcinoma. Am J Gastroenterol, 1989 (accepted for publication).Google Scholar
  20. 20.
    Marshall BJ, Goodwin CS, Warren JR, et al: Prospective double blind study of supplementary antibiotic therapy for duodenal ulcer associated with Campylobacter pyloridis infection. Am J Gastroenterol 81:889, 1986 (abstract)Google Scholar
  21. 21.
    Coghlan JG, Humphries H, Dooley C, et al: Campylobacter pylori and recurrence of duodenal ulcers: A 12-month follow-up study. Lancet 2:1109–1111, 1987PubMedCrossRefGoogle Scholar
  22. 22.
    Burnie J, Lee W: Virulence of Campylobacter strains and degree of gastritis. Lancet 1:302, 1988PubMedCrossRefGoogle Scholar
  23. 23.
    Langenberg W, Rows EAJ, Widjojokusomo A, et al: Identification of Campylobacter pyloridis isolates by restriction endohuclease DNA analysis. J Clin Microbiol 24:414–417, 1986PubMedGoogle Scholar
  24. 24.
    Hazell SL, Lee A, Brady L, Hennessy W: Campylobacter pyloridis and gastritis: Association with intercellular spaces and adaptation to an environment of mucus as important factors in colonization of the gastric epithelium. J Infec Dis 153:658–663, 1986CrossRefGoogle Scholar
  25. 25.
    Strickland RG, Mackay IR: A reappraisal of the nature and significance of chronic atrophic gastritis. Am J Dig Dis 18:426–440, 1973PubMedCrossRefGoogle Scholar
  26. 26.
    Lambert R: Chronic gastritis. Digestion 7:83–126, 1972PubMedCrossRefGoogle Scholar
  27. 27.
    Correa P: The epidemiology and pathogenosis of chronic gastritis: Three etiologic entities. Front Gastroenterol Res 6:98–108, 1980Google Scholar
  28. 28.
    Correa P: Chronic gastritis: A clinico-pathologic classification. Am J Gastroenterol 83:504–509, 1988PubMedGoogle Scholar
  29. 29.
    Correa P, Cuello C, Duque E, et al: Gastric cancer in Colombia. III. Natural history of precursor lesions. J Natl Cancer Inst 57:1027–1035, 1976PubMedGoogle Scholar
  30. 30.
    Chen XG, Correa P, Offerhaus J: Ultrastructure of the gastric mucosa harboring Campylobacter-like organisms. Am J Clin Path 86:575–582, 1986PubMedGoogle Scholar
  31. 31.
    Goodwin CS, Armstrong JA, Marshall BJ: Campylobacyter pyloridis, gastritis and peptic ulceration. J Clin Path 39:353–365, 1986PubMedCrossRefGoogle Scholar
  32. 32.
    Marshall BJ, McGechie DB, Roges PA, Glancy RJ: Pyloric Campylobacter infection and gastro-duodenal disease. Med J Aust 142:439–444, 1985PubMedGoogle Scholar
  33. 33.
    Krakowka S, Morgan DR, Kraft WG, Teunk RD: Establishment of gastric Campylobacter pylori infection in the neonatal gnotobiotic piglet. Infect Immun 55:2789–2796, 1987PubMedGoogle Scholar
  34. 34.
    O’Connor HJ, Wyatt JI, Dixon MF, Axon ATR: Campylobacter-like organisms and reflux gastritis. J Clin Path 39:531–534, 1986PubMedCrossRefGoogle Scholar
  35. 35.
    O’Connor HJ, Axon ATR, Dixon MF: Campylobacter-like organisms unusual in type A (pernicious anemia) gastritis. Lancet 2:1091, 1984PubMedCrossRefGoogle Scholar
  36. 36.
    Nomura A, Yamakawa H, Ishidate T, et al: Intestinal metaplasia in Japan. Association with diet. JNCI 68:401–405, 1981Google Scholar
  37. 37.
    Fontham E, Zavala D, Correa P: Diet and chronic atrophic gastritis: A case-control study. JNCI 76:621–627, 1986PubMedGoogle Scholar
  38. 38.
    Stemmermann GN, Haenszel W, Locke F: Epidemiologic pathology of gastric ulcer and gastric carcinoma among Japanese in Hawaii. JNCI 58:13–20, 1977PubMedGoogle Scholar
  39. 39.
    Price AB, Levi J, Dolby JM, et al: Campylobacter pyloridis in peptic ulcer disease: Microbiology, pathology and scanning electron microscopy. Gut 26:1183–1186, 1985PubMedCrossRefGoogle Scholar
  40. 40.
    Rathbone BJ, Wyatt J, Heatley RV: Campylobacter pyloridis. A new factor in peptic ulcer disease? Gut 27:635–641, 1986Google Scholar
  41. 41.
    Dooley CP, McKenna D, Humphreys H, et al: Histological gastritis in duodenal ulcer: Relationship to Campylobacter pylori and effect of ulcer therapy. Am J Gastroenterol 83:278–286, 1988PubMedGoogle Scholar
  42. 42.
    Hui WM, Lam SF, Chan PY, et al: Persistence of Campylobacter pyloridis despite healing of duodenal ulcer and improvement of accompanying duodenitis and gastritis. Dig Dis Sci 32:1255–1260, 1987PubMedCrossRefGoogle Scholar
  43. 43.
    Marshall BJ, Armstrong JA, Frances JG, et al: Antibacterial action of bismuth in relation to Campylobacter pyloridis colonization and gastritis. Digestion 37:16–30, 1987PubMedCrossRefGoogle Scholar
  44. 44.
    Raws EAJ, Langenberg W, Honthoff HJ, et al: Campylobacter pyloridis associated chronic active antral gastritis. Gastroenterology 94:33–40, 1988Google Scholar
  45. 45.
    Borody T, Cole P, Noonan A, et al: Long-term Campylobacter recurrence post eradication. Gastroenterology A43, 1988Google Scholar
  46. 46.
    Glupczynski Y, Burette A, Labbe M, et al: Campylobacter pylori associated gastritis: a double blind placebo controlled trial with amoxycillin. Am J Gastroenterol 83:365–372, 1988PubMedGoogle Scholar
  47. 47.
    Hui WM, Lam SK, Ho J, et al: Chronic antral gastritis in duodenal ulcer. Natural history and treatment with prostaglandin E. Gastroenterology 91:1095–1101, 1986Google Scholar
  48. 48.
    Wyatt JI, Rathbone BJ, Dixon MF, Heatley RV: Campylobacter pyloridis and acid induced gastric metaplasia in the pathogenesis of duodenitis. J Clin Path 40:841–848, 1987PubMedCrossRefGoogle Scholar
  49. 49.
    Gasman-Jones C: Pathogenesis of peptic ulcer disease and gastritis: Importance of aggressive and cytoprotractive factors. Scand J Gastroenterol 21, suppl 122:1–5, 1986CrossRefGoogle Scholar
  50. 50.
    Slomiany BL, Bilski J, Sarosiek J, et al: Campylobacter pyloridis degrades mucin and undermines gastric mucosal integrity. Biochem Biophys Res Commun 115:1053–1060, 1983PubMedCrossRefGoogle Scholar
  51. 51.
    Tytgat GNJ, Raws E, Langenberg W: The role of colloidal bismuth subcitrate in gastric ulcer and gastritis. Scandi J Gastroenterol 21, suppl 122:22–29, 1986CrossRefGoogle Scholar
  52. 52.
    McNulty CA, Gearty JC, Crump O, et al: Campylobacter pyloridis: Investigator blind, placebo controlled trial of bismuth salicilate and erythromicin ethylsucinate. Br Med J 293:645–649, 1986CrossRefGoogle Scholar
  53. 53.
    Gerson P, Yardley JH: Gastric and esophageal Campylobacter pylori in patients with Barrett’s esophagus. Gastroenterology 95:216–218, 1988Google Scholar
  54. 54.
    Pambianco DJ, Dye KR, Marshall BJ, et al: Gastritis in the rectum: Campylobacter like organisms in heterotopic inflamed gastric mucosa. Gastroenterology 94:A340, 1988 (abstract)Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1989

Authors and Affiliations

  • Pelayo Correa
  • Nubia Muñoz
  • Carlos Cuello
  • James Fox
  • Diego Zavala
  • Bernardo Ruiz

There are no affiliations available

Personalised recommendations