Document Detail


Nodular gastritis in adults: clinical features, endoscopic appearance, histopathological features, and response to therapy.
MedLine Citation:
PMID:  17614956     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND AIMS: The present study aims to determine the prevalence of nodular gastritis (NG) and ascertain its clinical presentation and histopathological features in adults. It also assesses its association with Helicobacter pylori and the normalization of endoscopic features, symptoms, and histology after anti H. pylori therapy. METHODS: A total of 7140 patients undergoing upper gastrointestinal endoscopy were studied. Patients showing nodularity of the gastric mucosa at endoscopy and an age- and sex-matched control group with normal gastric mucosa underwent biopsies from the gastric antrum and fundus. The biopsies were assessed for the presence of mucosal inflammation, activity, eosinophils, atrophy, lymphoid follicles, H. pylori, and the presence of intestinal metaplasia. Patients with NG were given triple therapy. Endoscopy and biopsy was repeated after 4 weeks of stopping therapy. The symptoms of the patients and histology were assessed pre- and post-therapy. RESULTS: Thirty-two patients with an age range of 20-65 years presenting with NG and 40 age- and sex-matched controls were included in the study. Presenting symptoms were epigastric pain (56%), nausea (75%), vomiting (50%) and abdominal bloating (62.5%). All these symptoms regressed significantly after 2 week of triple therapy against H. pylori. A marked improvement in histopathological features was seen post-therapy where the presence of lymphoid aggregates, eosinophils in the mucosa, atrophy, and intestinal metaplasia improved significantly (P < 0.05) after therapy, as compared to the control group of patients. CONCLUSION: The symptoms of NG and endoscopic features regress significantly after H. pylori therapy with a proton pump inhibitor and two antibiotics and should routinely be given to treat this form of gastritis. This may prevent progression to further complications.
Authors:
Manisha Dwivedi; Sri Prakash Misra; Vatsala Misra
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Publication Detail:
Type:  Journal Article     Date:  2007-07-06
Journal Detail:
Title:  Journal of gastroenterology and hepatology     Volume:  23     ISSN:  1440-1746     ISO Abbreviation:  J. Gastroenterol. Hepatol.     Publication Date:  2008 Jun 
Date Detail:
Created Date:  2008-06-20     Completed Date:  2008-11-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8607909     Medline TA:  J Gastroenterol Hepatol     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  943-7     Citation Subset:  IM    
Affiliation:
Departments of Gastroenterology and Pathology, Moti Lal Nehru Medical College, University of Allahabad, Allahabad, India. manisha_dwivedi@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Anti-Bacterial Agents / therapeutic use
Biopsy
Case-Control Studies
Drug Therapy, Combination
Female
Gastric Mucosa / drug effects*,  microbiology,  pathology
Gastritis / drug therapy,  epidemiology,  microbiology*,  pathology*
Gastroscopy*
Helicobacter Infections / complications*,  drug therapy,  epidemiology,  pathology*
Helicobacter pylori*
Humans
India / epidemiology
Male
Middle Aged
Prevalence
Proton Pump Inhibitors / therapeutic use
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents; 0/Proton Pump Inhibitors

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