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Alkalen reflü gastrit tanısı ile ursodeoksikolik asit tedavisi almış hastaların tedavi öncesi ve sonrası klinik, endoskopik ve histolojik bulgularının değerlendirilmesi

Giriş ve Amaç: Alkalen reflü gastrit asidik olmayan safranın mide içine reflüsüne verilen isimdir. Opere midede sık görülmekle birlikte cerrahi girişim geçirmeyen hastalarda da duodenogastrik antifeflü mekanizmalardaki bozukluk sonucunda ortaya çıkmaktadır. Medikal tedavisinde çeşitli ilaçlar kullanılmaktadır. Biz bu çalışmada cerrahi girişim geçirmemiş hastalarda ursodeoksikolik asitin klinik, endoskopik ve histolojik etkilerini incelemeyi amaçladık. Gereç ve Yöntem: Endoskopik inceleme sonucu alkalen reflü gastrit saptanan 72 hastaya ursodeoksikolik asit tedavisi verildi. İki aylık tedavi sonunda klinik, endoskopik ve histolojik bulgular değerlendirildi. Klinik değerlendirme 72 hastada, endoskopik ve histolojik değerlendirme ise kontrol endoskopi yaptıran 61 hasta üzerinden yapıldı. Bulgular: Hastaların 38’i (%52.7) kadın, 34’ü (%47.3) erkekti. En küçük yaş 19, en büyük yaş 81 olup, ortalama yaş 50 idi. Tedavi sonrası 72 hastanın 54’ü (%75) tedaviden fayda gördüğünü bildirdi. Kontrol endoskopi yapılan 61 hastanın 45’inde (%73.7) endoskopik tanı alkalen reflü gastrit olarak bildirilmedi. Kontrol histolojik inceleme yapılan 61 hastanın 6’sında (%9.9) kronik gastrit ve inflamasyon yerine normal mukoza saptandı. Sonuç: Ursodeoksikolik asit tedavisi verilen hastaların %75’inin klinik olarak tedaviden fayda gördüğü saptandı. Endoskopik olarak tedavi sonrası hastaların %73.7’sinde alkalen reflü gastrit saptanmadı. Histolojik olarak hastaların ancak %9.9’unda histolojik bulguların düzeldiği görüldü. Bu bulgularla alkali reflü gastrit tedaviside ursodeoksikolik asitin klinik ve endoskopik bulguların düzelmesinde etkili, histolojik bulguları düzeltmede ise etkisiz olduğunu söylemek mümkündür.

Anahtar Kelimeler:

Alkalen reflü, gastrit, ursodeoksikolik asit

Comparison of clinical, endoscopic, and histological features of patients diagnosed with alkaline reflux gastritis before and after ursodeoxycholic acid treatment

Abstract: Bacground and Aims. Alkaline reflux gastritis is characterized by non-acidic flow from the duodenum to the stomach. It is seen very commonly among operated patients. It can also be seen among non-operated patients, due to a defect in duodenogastric antireflux mechanisms. Various medications are used for its treatment. We aimed to analyze the clinical, endoscopic, and histological effects of ursodeoxycholic acid in non-operated patients in this study. Material and Methods. A total of 72 patients who were diagnosed with alkaline reflux gastritis as a result of endoscopic imagining were treated with ursodeoxycholic acid. Clinical, endoscopic, and histological features were analyzed after 2 months of treatment. A total of 72 patients were analyzed clinically, and 61 patients who had control endoscopy were analyzed endoscopically and histologically. Results. Of the total, 38 patients were female and 34 were male. The youngest and oldest patients were 19 and 81 years of age, respectively. The average age was 50 years. After treatment, 54 patients out of 72 reported benefits. Sixteen patients out of 61 who had control endoscopy were diagnosed endoscopically with alkaline reflux gastritis. Normal mucosa was observed instead of chronic gastritis and inflammation in 6 out of 61 patients who had control histological examination. Conclusion. In all, 75% of the patients who were treated with ursodeoxycholic acid recovered clinically. Altogether, 73.7% of patients recovered endoscopically. Only 9.9% of patients recovered histologically. In conclusion, ursodeoxycholic acid treatment is effective clinically and endoscopically but is ineffective histologically.

Keywords:

alkaline reflux, gastritis, ursodeoxycholic acid,

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