The role of gut microbiota disorders in the pathogenesis of helicobacter pylori associated gastritis

The aim: to study the correlation of qualitative and quantitative changes in gut microbiota with clinical, endoscopic, morphological and psychosomatic manifestations of chronic gastroduodenitis associated with Helicobacter pylori (HP). Materials and methods: 103 patients with chronic gastroduodenitis associated with HP were under observation. All patients underwent a comprehensive examination, which included: assessment of complaints, endoscopic examination of the upper gastrointestinal tract with assessment of hyperemia, edema, erosive changes in the gastric and duodenal mucosa, verification of HP infection (rapid urease test and histological examination), histological examination of the body and antral stomach mucosa with detection of neutrophil, lymphoplasmocytic infiltration, hemorrhages, edema, signs of atrophy, metaplasia, dysplasia), bacteriological examination of feces to assess the state of the gut microbiota, psychological testing to assess the level of anxiety and depression. To identify possible relationships between the manifestations of chronic gastroduodenitis and disorders of the colon microflora, a correlation analysis was performed. Results: a decrease in the content of representatives of the normoflora (bifidobacteria, lactobacilli, etc.) and an increase in the level of opportunistic microorganisms, staphylococci and yeast like fungi Candida spp. in the colon is associated with the severity of clinical manifestations of abdominal pain and dyspeptic syndromes, combined with an increase in the severity of inflammatory and subatrophic changes in the gastroduodenal zone, the appearance and increase in the number of erosions of the gastric mucosa and duodenum, with an increase in the degree of infection of Helicobacter pylori and with increased signs of chronic inflammation of the mucous membrane of both the body and the antrum of the stomach, as well as with increased severity of atrophy, metaplasia and foveolar hyperplasia (dysplasia), with increased anxiety, as well as a tendency to depression. Conclusions: The identification of the interrelationships of helicobacteriosis of the stomach and gut dysbiosis can contribute to the expansion of ideas about the pathogenesis of helicobacteriosis, as well as serve as a constructive basis for developing recommendations to improve the effectiveness and safety of treatment of diseases associated with Helicobacter pylori infection, in particular, through the use of drugs to correct disorders of the gut microbiota.