P.1.325: USEFULNESS OF SERUM PEPSINOGENS TO IDENTIFY CHRONIC ATROP H IC GASTRITIS
Andrea IoriLuigi GattaDario ValenzaPellegrino CrafaPietro CaruanaPatrizia PerazzoJ. FranzèBerardino VairaGiulia Martina CavestroA. FranzèMassimo RuggeCarmelo ScarpignatoFrancesco Di Mario
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Chronic gastritis
Chronic gastritis
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The authors analyze results of a study of 100 patients with chronic gastritis showing secretory insufficiency with a dubious diagnosis. Endoscopy and intragastric pH-metry were used. The diagnosis of chronic gastritis was confirmed in 35 patients and of them with secretory insufficiency only in 21 patients that evidences inadequate attention to the complaints, anamnesis, incomplete examination and use of laboratory and other data.
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Purpose: We aimed to investigate the effect of Helicobacter Pylorii (HP) on the development of gallbladder diseases and cholelithiasis and its relationship with gastritis.
Methods: 282 gastritis cases with follow-up and operated gallbladder material were included in the study. All histomorphological findings, presence of HP and other variables were compared. Active inflammation and presence of HP were examined in the gastritis group. The gallbladder (GB) disease group was evaluated in terms of cholelithiasis, inflammation, cholesterolosis, intestinal and pyloric metaplasia, and the presence of HP.
Results: Gallbladder HP (+) was higher in female patients than in male patients. The presence of HP in the GB was significantly higher in patients with cholelithiasis than patients without cholelithiasis. The incidence of HP in the GB was higher in patients with active gastritis than in patients with inactive gastritis. The presence of HP in the GB was found to be higher in patients with HP on gastric biopsy. HP was found to be less in cases without cholesterolosis in the GB (p
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Journal Article Helicobacter pylori Infection in Elderly Dyspeptic Patients Get access THOMAS G. O'RIORDAN, THOMAS G. O'RIORDAN Departments of Gastroenterology, Meath/Adelaide HospitalsDublin Search for other works by this author on: Oxford Academic PubMed Google Scholar ANN TOBIN, ANN TOBIN Departments of Gastroenterology, Meath/Adelaide HospitalsDublin Search for other works by this author on: Oxford Academic PubMed Google Scholar COLM Ó'MORÁIN COLM Ó'MORÁIN Departments of Gastroenterology, Meath/Adelaide HospitalsDublin Address correspondence to: Department of Gastroenterology, Adelaide Hospital, Peter Street, Dublin 8, Republic of Ireland Search for other works by this author on: Oxford Academic PubMed Google Scholar Age and Ageing, Volume 20, Issue 3, May 1991, Pages 189–192, https://doi.org/10.1093/ageing/20.3.189 Published: 01 May 1991 Article history Received: 10 August 1990 Revision received: 10 August 1990 Published: 01 May 1991
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Atrophic gastritis
Pepsin
Spirillaceae
Rapid urease test
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Chronic gastritis
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AbstractChronic (atrophic) gastritis is a progressive disease which in a small proportion of patients leads to severe (total) atrophy (severe grade of chronic gastritis) of the antral or body mucosa or both. Chronic gastritis is a premalignant condition which favours the development of gastric cancer. Chronic gastritis precedes gastric cancer and shows a severalfold increase in the risk of gastric cancer compared to subjects with histologically normal stomachs. Several tentative modifications to the estimate of the risks may be presented: (i) a severe risk of developing gastric cancer is restricted to subjects with a severe grade of chronic gastritis (ii) the risk of gastric cancer is increased in subjects who have either severe antral or body chronic gastritis, the risk being approximately three to five times higher in the antral chronic gastritis (B-type of gastritis) than in the body chronic gastritis (A type of gastritis); (iii) the antral and body chronic gastrites are independent risk factors for gastric cancer, the joint risks being multiplicands of the marginal risks i.e., the estimated risk is highest in those subjects who show severe chronic gastritis in both the antrum and the body (AB type of gastritis); (iiii) the chronic gastritis mediated gastric cancer risk is limited to gastric cancers of the intestinal type, and thus covers only a proportion of all cases of gastric cancer. In the highest risk groups it may be estimated that the probability of a subject developing gastric cancer in subsequent decades is up to 30% if the subject is a young man who has severe chronic gastritis in his antrum, or who has it coexistently in the antrum and body.Key Words: gastric cancerchronic atrophic gastritiscancer risk.
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Helicobacter pylori status, gastric histology, and 24 hour acidity were studied in 35 gastritis patients, 21 duodenal ulcer patients, and 14 subjects with normal gastric mucosa. H pylori was identified in 21 of 35 patients with chronic active gastritis and in 19 of 21 duodenal ulcer patients, but in none of those with normal gastric mucosa. Mean scores of activity of gastritis were similar in H pylori positive gastritis and duodenal ulcer patients, but were significantly lower in H pylori negative gastritis patients (2.1 (0.8) and 2.3 (0.9) v 1.4 (0.7); p < 0.01, respectively). Median 24 hour hydrogen ion activity (interquartile range) was 21 (8.9-38.0) mmol/l in normal subjects and 23 (11.2-49.0) mmol/l, 19 (7.1-33.1) mmol/l, 44 (25.1-63.1) mmol/l, and 36 (31.6-39.8) mmol/l respectively in gastritis and duodenal ulcer patients with and without H pylori infection. During all predefined time periods, intragastric acidity was significantly higher in patients with H pylori positive duodenal ulcers compared with gastritis patients and normal subjects. However, there was no significant difference in intragastric acidity between the H pylori positive and negative gastritis patients. These results suggest that most of the subjects with chronic H pylori infection have normal gastric acidity.
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Background: Helicobacter pylori gastritis is usually a lifelong disease which can cause different topographical inflammatory reactions and induce divergent effects on acid secretion in humans. High acid output and antrum-predominant gastritis are associated with duodenal ulcer disease, whereas corpuspredominat gastritis has been associated with low acid output and risk of gastric carcinoma. The objective of this study was to evaluate the role of different gastritis subtypes in the long-term treatment response of H. pylori -positive functional dyspepsia. Methods: The gastric biopsies from 143 H. pylori- positive patients with functional dyspepsia were classified in accordance with the Sydney System as antrumpredominant gastritis, pangastritis or corpus-predominant gastritis. The patients were randomized to receive either eradication therapy or placebo antibiotics. Moreover, to standardize acid suppression every patient received omeprazole therapy for the first 3 months. Dyspeptic symptoms were evaluated from a questionnaire and the follow-up time was 12 months. In addition, delta-over-baseline (DOB) values of the 13C-urea breath test (UBT) were analysed from a subgroup of 36 patients to measure urease activity of the stomach. Results: After 1 year, the dyspepsia symptom score was 7.4 ± 3.0 (95% CI 6.6-8.2) in successfully H. pylori -eradicated patients and 7.6 ± 3.1 (95% CI 6.9-8.4) in controls ( P = ns). Among patients with antrum-predominant gastritis, dyspepsia score was reduced more in subjects whose H. pylori was eradicated than in controls with ongoing infection (-3.6 ± 2.9 versus-1.7 ± 2.9; P = 0.05). High urease activity of the stomach was associated with severe or moderate chronic antrum-predominant gastritis. Conclusions: Patients with antrum-predominant H. pylori -positive chronic gastritis and functional dyspepsia get symptom improvement after successful eradication therapy. A high DOB value of UBT is associated with these patients.
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AbstractA series comprising 63 patients with gastric ulcer and 86 with duodenal ulcer is presented. Basal and maximal Histalog tests (1.5 mg/kg) were made. Biopsies were taken from resected specimens. In the patients with gastric ulcer the mean MAO value was 12.0 mEq/h and in those with duodenal ulcer 29 mEq/h. Among the gastric ulcer patients antral and body gastritis was significantly more frequent than among the duodenal ulcer patients. Antral gastritis was significantly commoner than body gastritis in both types of ulcer. The MAO and the prevalence of antral and body gastritis were not dependent on either the duration of the illness or the age of the patient. The severity of the antral gastritis bore no relation to the mean MAO values in the gastric or duodenal ulcer patients, but there was a negative correlation between body gastritis and the mean MAO values in both groups of patients. Depending upon the site of the ulcer, there was a statistically significant decrease in the mean MAO values from the duodenum to the proximal part of the stomach.Key-words: Acid secretionduodenal ulcergastric ulcergastritis
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