Document Detail


Patterns of gastritis in patients with gastro-oesophageal reflux disease.
MedLine Citation:
PMID:  10562575     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The cause of inflammation in cardiac mucosa at the gastro-oesophageal junction (GOJ) is unclear, both gastro-oesophageal reflux disease (GORD) and Helicobacter pylori having been implicated. AIMS: To describe patterns of gastritis in patients with symptomatic GORD. METHODS: In 150 patients (126 normally located Z-line, 24 Barrett's oesophagus) with symptoms of GORD, biopsies were taken of the GOJ, corpus, and antrum. Inflammation was assessed using the updated Sydney System. RESULTS: For the 126 patients with a normally located Z-line, biopsies of the GOJ revealed cardiac mucosa in 96, fundic mucosa in 29, and squamous mucosa in one. Inflammation in glandular mucosa at the GOJ was present in 99/125 specimens (79%), including 87/96 (91%) with cardiac mucosa and 12/29 (41%) with fundic mucosa. Inflammation in fundic mucosa was closely related to H pylori and active inflammation was only seen in its presence. Inflammation in cardiac mucosa was less closely linked to H pylori. When H pylori was present in cardiac mucosa (28/96, 29%) active inflammation was usually present (25/28, 89%). However, active inflammation was also found in 34/68 (50%) cardiac mucosa specimens without H pylori. Overall, 28/87 (32%) biopsies with carditis were colonised with H pylori and 59/87 (68%) were not. In H pylori colonised patients, inflammation was seen throughout the stomach, while in non-colonised patients, it was confined to cardiac mucosa. CONCLUSIONS: Patients with symptomatic GORD had a high prevalence of carditis. This was of two types, H pylori associated and unassociated. Except on Giemsa staining, the two were morphologically identical, suggesting mediation by a similar immunological mechanism.
Authors:
D J Bowrey; G W Clark; G T Williams
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Gut     Volume:  45     ISSN:  0017-5749     ISO Abbreviation:  Gut     Publication Date:  1999 Dec 
Date Detail:
Created Date:  2000-01-19     Completed Date:  2000-01-19     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  2985108R     Medline TA:  Gut     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  798-803     Citation Subset:  AIM; IM    
Affiliation:
University Department of Surgery, University of Wales College of Medicine, Cardiff, UK.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Biopsy
Cardia / microbiology,  pathology
Esophagogastric Junction / pathology
Female
Gastric Mucosa / microbiology,  pathology
Gastritis / etiology*,  microbiology
Gastroesophageal Reflux / complications*
Helicobacter Infections / complications
Helicobacter pylori / isolation & purification
Humans
Male
Metaplasia
Middle Aged
Comments/Corrections
Comment In:
Gut. 1999 Dec;45(6):793-4   [PMID:  10562571 ]

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