Muhammet Fatih AYDIN, Şule NAMLI KOÇ, Mehmet Akif AYDIN, Hüseyin AKYOL

Safra reflüsü bulunan ve bulunmayan gastrit hastalarında gastrik mukozal atrofi, intestinal metaplazi ve Helicobacter pylori durumu: Safra iyi mi kötü mü?

Giriş ve Amaç: Mideye safra asidi reflüsü ve atrofi ile intestinal metaplazi riski çeşitli çalışmalarda ele alınmış ve farklı sonuçlar elde edilmiştir. Bu çalışmanın amacı gastrit hastalarında safra reflüsünün gastrik mukozal atrofi, intestinal metaplazi ve Helicobacter pylori arasındaki ilişkiyi araştırmaktır. Gereç ve Yöntem: Çalışmaya gastrit bulunan toplam 217 hasta dahil edilmiş olup hastalar, intragastrik safra reflüsü bulunan (134 hasta) (n=20 patoloji ile doğrulanmış) ve safra reflüsü bulunmayan 83 hasta kontrol grubu olmak üzere iki gruba ayrılmıştır. Helicobacter pylori durumu ve intestinal metaplazi ile gastrit atrofi varlığı, safra reflüsü ve safra reflüsü gastriti varlığı açısından değerlendirilmiştir. Bulgular: Safra reflüsü bulunan ve bulunmayan gastrit hastaları arasında Helicobacter pylori pozitifliği (%38.8 vs %45.8), intestinal metaplazi (%32.8 vs %33.7) ve gastrik atrofi (%30.6 vs %30.1) açısından anlamlı fark saptanmamıştır. Bununla birlikte safra reflüsü gastritinin patolojik doğrulama eksikliği anlamlı derecede daha düşük Helicobacter pylori pozitifliği (%0.00 vs %45.6, p=0.001), intestinal metaplazi (%5.0 vs %37.7, p=0.009) ve gastrik atrofi (%0.0 vs %36.0, p=0.003) ile ilişkili bulunmuştur. Sonuç: Bulgularımız safra reflüsü bulunan ve bulunmayan gastrit hastaları arasında Helicobacter pylori poizitifliği, intestinal metaplazi ve gastrik atrofi oranlarının benzer olduğunu ortaya çıkarmıştır. Ancak patolojik olarak doğrulanan safra gastriti bulunan hastalarda Helicobacter pylori, metaplazi ve atrofi sıklığının daha az olduğu saptanmıştır.

Anahtar Kelimeler:

Safra reflüsü gastriti, gastrik mukozal atrofi, intestinal metaplazi, Helicobacter pylori durumu

Gastric mucosal atrophy, intestinal metaplasia, and Helicobacter pylori status in patients with gastritis with or without bile reflux: Is the presence of bile reflux good or bad?

Background and Aims: To investigate the relation between bile reflux and gastric mucosal atrophy, intestinal metaplasia, and Helicobacter pylori status in patients with gastritis. Materials and Methods: A total of 217 patients (mean ± SD; age: 33.2±7.9 years; 51.2% males) with gastritis were divided into two groups: patients with intragastric bile reflux (n = 134; confirmed by pathology in 20 patients) and without bile reflux (control group; n = 83). The status of Helicobacter pylori and presence of intestinal metaplasia and gastric atrophy were evaluated with respect to the presence of bile reflux. Results: A positive Helicobacter pylori status, intestinal metaplasia, and gastric atrophy were observed in 85 (39.2%), 72 (33.2%), and 66 (30.4%) patients, respectively. No significant difference was noted between patients with gastritis with or without bile reflux in terms of a positive Helicobacter pylori status (38.8% vs. 45.8%), intestinal metaplasia (32.8% vs. 33.7%), and gastric atrophy (30.6% vs. 30.1%). However, the pathological confirmation of bile reflux gastritis was associated with a significantly lower rate of Helicobacter pylori positivity (0.0% vs. 45.6%; p = 0.001), intestinal metaplasia (5.0% vs. 37.7%; p = 0.009), and gastric atrophy (0.0% vs. 36.0%; p = 0.003). In patients with bile reflux (n = 134), the intestinal metaplasia and gastric mucosal atrophy rates were similar with respect to the H. pylori status. Conclusion: The rates of Helicobacter pylori positivity, intestinal metaplasia, and gastric atrophy were similar in patients with gastritis with or without bile reflux. However, the frequency of Helicobacter pylori, intestinal metaplasia, and gastric mucosal atrophy was lower in patients with pathologically confirmed biliary gastritis.

Keywords:

Bile reflux gastritis, gastric mucosal atrophy, intestinal metaplasia, Helicobacter pylori status,

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