Symptomatic significance of gastric mucosal changes after surgery for peptic ulcer.

Eighty-four patients who had undergone different types of operation for duodenal ulcer have been studied by endoscopy and gastric biopsy. Half suffered from dyspepsia and vomiting but the other half had no symptoms and acted as controls. Endoscopic and histological abnormalities were found in both groups of patients. However, certain findings occurred more commonly in those with symptoms; severe and extensive hyperaemia, bile staining of the gastric mucus, and bile reflux seen on endoscopy were all significantly more common in those with symptoms than in those without. Active gastritis in the proximal stomach was also more common in those with symptoms. Gastritis of the stoma and antrum was found in 89% of all patients; as it was unconnected with symptoms it can be regarded as a "normal" finding. The incidences of contact bleeding, erosions, and oedema were not significantly different in the two groups.