Evaluation of intestinal metaplasia associated with alkaline reflux gastritis and Helicobacter pylori in patients without gastric surgery

Aim: Alkaline reflux gastritis is a term used for gastric mucosa damage due to reflux of duodenal and pancreatic content into stomach. In addition to many histopathological changes caused by alkaline reflux gastritis, the relationship of alkaline reflux gastritis with intestinal metaplasia is also important. Gastric intestinal metaplasia is a precancerous lesion that requires a follow-up protocol.Material and Methods: This study included 1005 patients who underwent esophagogastroduodenoscopy and were diagnosed with alkaline reflux gastritis at Endoscopy Unit of Gastroenterology Department of Karabük University, Medical School between January 2013 and January 2016.Results: When the data of these patients were retrospectively reviewed, intestinal metaplasia was detected in 203 patients (20.2%), whereas Helicobacter pylori was detected in 466 patients (46.4%). There was pyloric dysfunction in 359 patients (35.7%) but 646 patients (64.3%) did not have pyloric dysfunction.Conclusion: In our study, it was found that there was an increase in the frequency of intestinal metaplasia in patients with alkaline reflux gastritis who had increased with age, male gender and Helicobacter pylori. This was a retrospective study indicating the association of H. pylori with intestinal metaplasia in patients with alkaline reflux gastritis. We think that there is a need for further prospective studies to investigate the presence of intestinal metaplasia in patients with alkaline reflux gastritis

PDF

___

Kong YJ, Yi HG, Dai JC, Wei MX. Histological changes of gastric mucosa after H. pylori eradication: a systematic review and meta-analysis. World J Gastroenterol 2014;20(19):5903-11.
de Vries AC, van Grieken NC, Looman CW, Casparie MK, de Vries E, Meijer GA, et al. Gastric cancer risk in patients with premalignant gastric lesions: a nationwide cohort study in the Netherlands. Gastroenterology 2008;134(4):945-52.
Craanen ME, Dekker W, Blok P, Ferwerda J, Tytgat GN. Intestinal metaplasia and Helicobacter pylori: an endoscopic bioptic study of the gastric antrum. Gut 1992;33(1):16-20.
Scalon P, Di Mario F, Del Favero G, Meggiato T, Rugge M, Baffa R, et al. Biochemical and histopathological aspects in duodenogastric reflux gastritis patients with or without prior cholecystectomy. Acta Gastroenterol Belg 1993;56(2):215-8.
Fukuhara K, Osugi H, Takada N, Takemura M, Lee S, Taguchi S, et al. Duodenogastric reflux eradicates Helicobacter pylori after distal gastrectomy. Hepato-gastroenterology 2004;51(59):1548-50.
O’Connor HJ, Wyatt JI, Dixon MF, Axon AT. Campylobacter like organisms and reflux gastritis. J Clin Pathol 1986;39(5):531-4.
Marshall RE, Anggiansah A, Owen WA, Manifold DK, Owen WJ. The extent of duodeno gastric reflux in gastrooesophageal reflux disease. Eur J Gastroenterol Hepatol 2001;13(1):5-10.
Abdel-Wahab M, Abo-Elenein A, Fathy O, Gadel-Hak N, Elshal MF, Yaseen A, et al. Does cholecystectomy affect antral mucosa? Endoscopic, histopathologicand DNA flowcytometric study. Hepato-Gastroenterology 1999;47:621-5.
Feldman M, Friedman LS, Brandt LJ, editors. Sleisenger and Fordtran’s Gastrointestinal and Liver Disease, 10th Edition, Elsevier, 1;881
Whiting JL, Sigurdsson A, Rowlands DC, Hallissey MT, Fielding JW. The long term results of endoscopic surveillance of premalignant gastric lesions. Gut 2002;50(3):378-81.
Liu KS, Wong IO, Leung WK. Helicobacter pylori associated gastric intestinal metaplasia: Treatment and surveillance. World J Gastroenterol 2016;22:(3)1311-20.
Sobala GM, O’Connor HJ, Dewar EP, King RF, Axon AT, Dixon MF. Bile reflux and intestinal metaplasia in gastricmucosa. J ClinPathol 1993;46(3):235-40.
Chen SL(1), Mo JZ, Cao ZJ, Chen XY, Xiao SD. Effects of bile reflux on gastric mucosal lesions in patients with dyspepsia or chronic gastritis. World J Gastroenterol 2005;11:2834-7.
Vere CC, Cazacu S, Comănescu V, Mogoantă L, Rogoveanu I, Ciurea T. Endoscopical and histological features in bile reflux gastritis. Rom J Morphol Embryol 2005;46(4):269-74.