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Sections from 200 cholecystectomy specimens were searched microscopically for areas of gastric metaplasia and Helicobacter (Campylobacter) pylori colonization. The presence of gastric metaplasia was confirmed in 31 cases by the presence of tall columnar cells with abundant apical neutral mucin. Examination of haematoxylin and eosin and, in some cases, Warthin-Starry stained sections failed to demonstrate H. pylori in any of these 31 cases or in 29 other cases with 'bladder neck-type mucous gland metaplasia'. The failure of H. pylori to colonize areas of gastric metaplasia in the gall bladder confirms their intolerance to high concentrations of bile.
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