11.   On logistic regression, the presence and extent of gastric metaplasia was not significantly associated with H pylori infection.

12.   Gastric metaplasia is considered to be an acquired change of the surface epithelium.

13.   Heterotopia is less common than gastric metaplasia and not associated with duodenal inflammation or ulceration.

14.   But gastric metaplasia may also develop as a non-specific response to mucosal injury not associated with acid peptic damage.

15.   Wyatt et al found gastric metaplasia to be more extensive in patients with Helicobacter pylori associated gastritis than in patients without H pylori infection.

16.   Thus both H pylori infection and acid induced gastric metaplasia are considered to be prerequisites for the development of duodenitis with polymorphonuclear activity and duodenal ulcer.

17.   It has also been found that duodenal ulcer patients on continuous pharmacological acid suppression exhibit a lower prevalence of gastric metaplasia in comparison with intermittently treated patients.

18.   These findings suggest that gastric metaplasia is potentially a reversible disorder.

19.   To determine the extent of gastric metaplasia, multiple biopsy specimens were collected from standardised sites of the duodenal bulb.

20.   The mean extent of gastric metaplasia in all biopsy specimens collected before eradication was compared with the extent of gastric metaplasia at least one year after eradication.