Xiao Bo Li1, Hong Lu, Hui Min Chen, Xiao Yu Chen, Zhi Zheng Ge. 1. Department of Gastroenterology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai Institute of Digestive Disease, Shanghai, China.
Abstract
OBJECTIVE: The influence of the main pathogenic factors on remnant gastritis is still to be evaluated. The aim of this study was to investigate the role of bile reflux and Helicobacter pylori infection on endoscopic inflammation and histological changes of gastric remnant after distal gastrectomy. METHODS: A total of 281 patients with a more than 1-year history of distal gastrectomy were retrospectively involved after excluding those with tumors and ulcers on endoscopy. The severity of endoscopic remnant gastritis and bile reflux were recorded during the endoscopy. The histological changes including chronic inflammation, activity, atrophy, intestinal metaplasia and H. pylori were evaluated independently. RESULTS: An endoscopic inflammation of remnant gastric mucosae was found in 81.1% (228/281) of the patients. The prevalence of H. pylori infection and bile reflux in patients with endoscopic remnant gastritis was more common than in those without gastritis (21.5%vs 0%, 88.6%vs 24.5%, P < 0.0001). The score of histological chronic inflammation was significantly higher in patients with bile reflux than in those without obvious bile reflux (1.65 vs 1.45, P = 0.02). Chronic inflammation (1.82 vs 1.57), activity (0.78 vs 0.34), atrophy (0.67 vs 0.41) and intestinal metaplasia (0.67 vs 0.27) in H. pylori-positive patients were all significantly more severe than in H. pylori-negative patients. CONCLUSION: Bile reflux and H. pylori infection exacerbates the severity of endoscopic remnant gastritis and chronic histological inflammation.
OBJECTIVE: The influence of the main pathogenic factors on remnant gastritis is still to be evaluated. The aim of this study was to investigate the role of bile reflux and Helicobacter pyloriinfection on endoscopic inflammation and histological changes of gastric remnant after distal gastrectomy. METHODS: A total of 281 patients with a more than 1-year history of distal gastrectomy were retrospectively involved after excluding those with tumors and ulcers on endoscopy. The severity of endoscopic remnant gastritis and bile reflux were recorded during the endoscopy. The histological changes including chronic inflammation, activity, atrophy, intestinal metaplasia and H. pylori were evaluated independently. RESULTS: An endoscopic inflammation of remnant gastric mucosae was found in 81.1% (228/281) of the patients. The prevalence of H. pyloriinfection and bile reflux in patients with endoscopic remnant gastritis was more common than in those without gastritis (21.5%vs 0%, 88.6%vs 24.5%, P < 0.0001). The score of histological chronic inflammation was significantly higher in patients with bile reflux than in those without obvious bile reflux (1.65 vs 1.45, P = 0.02). Chronic inflammation (1.82 vs 1.57), activity (0.78 vs 0.34), atrophy (0.67 vs 0.41) and intestinal metaplasia (0.67 vs 0.27) in H. pylori-positive patients were all significantly more severe than in H. pylori-negative patients. CONCLUSION: Bile reflux and H. pyloriinfection exacerbates the severity of endoscopic remnant gastritis and chronic histological inflammation.
Authors: Kichul Yoon; Nayoung Kim; Jaeyeon Kim; Jung Won Lee; Hye Seung Lee; Jong-Chan Lee; Hyuk Yoon; Cheol Min Shin; Young Soo Park; Sang-Hoon Ahn; Do Joong Park; Hyung Ho Kim; Yoon Jin Lee; Kyoung-Ho Lee; Young-Hoon Kim; Dong Ho Lee Journal: Gut Liver Date: 2017-03-15 Impact factor: 4.519
Authors: Dan Li; Jian Zhang; Wen Zhu Yao; Dong Lin Zhang; Chen Chen Feng; Qi He; Huan Huan Lv; Ya Ping Cao; Jie Wang; Ying Qi; Si Ran Wu; Na Wang; Jing Zhao; Yong Quan Shi Journal: J Dig Dis Date: 2020-04-21 Impact factor: 2.325