Background: Smoking is hazardous to almost any organ in the body and has a harmful effect on the gastric mucosa. Objective: The main goal of this study was to evaluate the synergistic effect of smoking and H . pylori infection on gastric mucosal among dyspeptic Egyptian patients. Patients and Methods: A cross-sectional study was conducted among 240 consecutive patients with dyspepsia who underwent upper endoscopy and histopathological examination of gastric biopsies at Zagazig and Tanta University Hospital with H . pylori -positivity assessment by stool antigen and rapid urease test. Results: There were 60 smoker patients and 180 non-smoker patients. Erosive gastritis was more prevalent in smoker patients than non-smoker patients (46.7% versus 15.6%, p = 0.00). In H . pylori -positive patients (36.7% of all patient s ), smokers were more prevalent than non-smokers in the development of intestinal metaplasia (20% versus 0% , p = 0.003) , erosive gastritis (80% versus 30% , p = 0.00), glandular atrophy (20% versus 0% , p = 0.003) and reactive gastropathy (20% versus 0% , p = 0.003). Conclusions: This study revealed that smoking may increase the prevalence of having gastric intestinal metaplasia, erosive gastritis, glandular atrophy and reactive gastropathy in H . pylo ri -positive Egyptian patients.
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