The Transitional Zone - The Key to Understanding H. pylori-associated Disease

Long before the discovery of Helicobacter pylori, there were many excellent observational studies that documented differences in the patterns of gastroduodenal disease. It was clear that in the developing world, gastric ulcer and gastric cancer were more common than in the developed world where duodenal ulcer predominated. This correlated with the distribution of gastritis in duodenal ulcer patients where the inflammation was antral predominant while in gastric ulcer patients the gastritis was more evenly distributed through the stomach. Gastric ulcers usually appeared in a fairly restricted distribution in the stomach near the angulus and close to the transitional zone between antrum and body mucosa. As a so ciety developed sothese patterns of disease changed.