No relation was found between inflammation and intestinal metaplasia of gastric mucosa and the development of gastroesophageal reflux disease among Japanese patients

ABSTRACT Background and objectives: Proton pump inhibitors are used widely for gastroesophageal reflux disease and ulcer type dyspepsia. Majority of the patients require long term medication. H2 receptor antagonist are also used for relief of symptoms. Though tachyphylaxis has been reported, symptom response is seen with long term use. The aim of the present study was to study the effects of long-term acid suppressants on gastric antral histology. Methods: Patients who received long-term acid suppressants such as ranitidine and omeprazole for gastroesophageal reflux disease or dyspepsia were included. All of them had an antral biopsy for histology and H. pylori status at baseline, at 6 months and 12 months. Patients on acid suppressants for less than a year or on long-term non-steroidal anti inflammatory drugs were excluded from the study. The grading of gastritis was classified as chronic active gastritis, atrophic gastritis, intestinal metaplasia and dysplasia. Results: Thirty patients received ranitidine and 28 omeprazole. In H. pylori positive group, the median duration of ranitidine and omeprazole were 3 years (1.5 to 8 years) and 4 years (1 to 10 years) respectively. Two thirds of patients had chronic active gastritis (ranitidine: 35.5% omeprazole:26.6%); 10 had gastric atrophy (ranitidine: 6.6% omeprazole:15.5%) and 7 had intestinal metaplasia (ranitidine4.4% omeprazole11.1%). Four of the 10 patients on omeprazole showed progression of histology as against only one of the 13 patients on ranitidine at one year of follow up. In omeprazole pylori negative patients, the median duration of ranitidine and omeprazole was 2.5 years (range 1 to 6 years) and 3 years (range 2 to 7 years) respectively. Irrespective of the acid suppressants, the baseline histology was either chronic active gastritis (78.5%) or gastric atrophy (21.5%). None had intestinal metaplasia. Also there was no progression in histology staging during the follow up. Conclusions: Long-term acid suppressants irrespective of the H. pylori status are not associated with significant histological changes in gastric mucosa. Despite a significant drop out of cases, among the cases followed up no significant progression in histological staging was seen during a one year follow-up. (J Dig Endosc 2013;4(1):1–5)

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Helicobacter pylori infection reduces the risk of gastroesophageal reflux disease

Experimental and Clinical Gastroenterology ◽

10.31146/1682-8658-ecg-193-9-96-101 ◽

2021 ◽

pp. 96-101

Author(s):

R. I. Khlynova ◽

O. M. Khromtsova ◽

R. B. Berdnikov ◽

I. B. Khlynov

Keyword(s):

Helicobacter Pylori ◽

Gastroesophageal Reflux Disease ◽

Gastric Mucosa ◽

Gastroesophageal Reflux ◽

Observational Study ◽

Reflux Disease ◽

Helicobacter Pylori Infection ◽

Cross Sectional ◽

Biopsy Specimens ◽

H Pylori

The aim is to study the effect of Helicobacter pylori infection on risk of developing gastroesophageal reflux disease. Materials and methods - cross-sectional observational study of 1007 patients with dyspepsia syndrome who underwent videoesophagogastroduodenoscopy with biopsy and histological examination of biopsy specimens of the gastric mucosa by OLGA-system. The age, gender, overweight, cigarette smoking, presence of Helicobacter pylori infection and gastritis stage were assessed. Results - the study showed a significant decrease in the incidence of gastroesophageal reflux disease in patients with positive H. Pylori status by 4% (RR 0,68; 95% CI, 0.49-0.94, p=0,041). The risk of developing gastroesophageal reflux disease significantly higher in overweight (RR 2,62; 95% CI 2,0-3,56; р<0,001) men (RR 1,76; 95% CI 1,33-2,32; р=0,0046) who smoked cigarettes (RR 3,23; 95% CI 2,45-4,24; р<0,001) and was not associated with the patient’s age and the stage of gastritis (р>0,05). Conclusion - a significant reduction in the frequency and risk of developing gastroesophageal reflux disease in patients with Helicobacter pylori infection is demonstrated.

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Intestinal metaplasia of the cardia and infection with caga-positive Helicobacter pylori strains in gastroesophageal reflux disease

Gastroenterology ◽

10.1016/s0016-5085(00)81027-6 ◽

2000 ◽

Vol 118 (4) ◽

pp. A1293

Author(s):

O. Pieramico ◽

R. Vendramin ◽

M.V. Zanetti

Keyword(s):

Helicobacter Pylori ◽

Gastroesophageal Reflux Disease ◽

Gastroesophageal Reflux ◽

Intestinal Metaplasia ◽

Reflux Disease

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Clinical characteristics and effectiveness of lansoprazole in Japanese patients with gastroesophageal reflux disease and dyspepsia

Journal of Gastroenterology ◽

10.1007/s00535-013-0812-3 ◽

2013 ◽

Vol 49 (4) ◽

pp. 628-637 ◽

Cited By ~ 7

Author(s):

Yoshikazu Kinoshita ◽

Hiroto Miwa ◽

Katsuyuki Sanada ◽

Koji Miyata ◽

Ken Haruma

Keyword(s):

Gastroesophageal Reflux Disease ◽

Gastroesophageal Reflux ◽

Reflux Disease ◽

Clinical Characteristics ◽

Japanese Patients

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The role of interleukin 1β and interleukin 1 receptor antagonist polymorphism genes, Helicobacter pylori infection and the state of the gastric mucosa in the development and progression of gastroesophageal reflux disease

Pacific Medical Journal ◽

10.34215/1609-1175-2020-4-44-48 ◽

2020 ◽

pp. 44-48

Author(s):

A. A. Zhilina ◽

N. V. Lareva ◽

E. V. Luzina

Keyword(s):

Helicobacter Pylori ◽

High Risk ◽

Gastroesophageal Reflux Disease ◽

Gastric Mucosa ◽

Gastroesophageal Reflux ◽

Receptor Antagonist ◽

Reflux Disease ◽

Local Level ◽

Erosive Esophagitis ◽

Esophagus Cancer

The mechanisms of the gastroesophageal reflux disease (GERD) development and its complications are analyzed on the tissue and cell levels. That’s why studying polymorphism of interleukin (IL) genes is important. Genotypes IL1β-511Т/Т, IL1β31С/С and IL1RN2/2 (receptor antagonist IL1) associate with high risk of complicated course of GERD disease. Researching genes polymorphism of the pro-inflammatory cytokines of the patients having gastroesophageal reflux disease and changes in gastric mucosa it was determined that genotype IL1β-511Т/Т is associated with the deeper local level of IL1β. Meanwhile the patients having erosive esophagitis had lover level of IL1β. It was determined that genotype IL1RN2/2 and haplotype IL1RN*2 /IL1В-31*Т are connected with the high risk of esophagus cancer of patients having Helicobacter pylori. Genotype IL1β-511Т/Т and haplotype IL1β-511Т/Т /IL1RN1/1 of the patients having GERD are associated with the low risk of the esophagus cancer. So, the allele IL1RN*2 and genotype IL1RN2/2 can combine by independent predictors of GERD progression. The study of this field should be continued taking into account not only changes in gastric mucosa, presence of helicobacteriosis, but also the nature of gastroesophageal reflux.

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Inflammation and Specialized Intestinal Metaplasia of Cardiac Mucosa Is a Manifestation of Gastroesophageal Reflux Disease

Annals of Surgery ◽

10.1097/00000658-199710000-00013 ◽

1997 ◽

Vol 226 (4) ◽

pp. 522-532 ◽

Cited By ~ 218

Author(s):

Stefan Öberg ◽

Jeffrey H. Peters ◽

Tom R. DeMeester ◽

Para Chandrasoma ◽

Jeffrey A. Hagen ◽

...

Keyword(s):

Gastroesophageal Reflux Disease ◽

Gastroesophageal Reflux ◽

Intestinal Metaplasia ◽

Reflux Disease ◽

Cardiac Mucosa ◽

Specialized Intestinal Metaplasia

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Peculiarities of the Pathology of Gastrointestinal Tract in Patients with Gastroesophageal Reflux Disease on the Background of Hypothyroidism

Ukraïnsʹkij žurnal medicini bìologìï ta sportu ◽

10.26693/jmbs06.01.125 ◽

2021 ◽

Vol 6 (1) ◽

pp. 125-131

Author(s):

Reva T. V. ◽

◽

V. B. Reva ◽

I. V. Trefanenko ◽

G. І. Shumko ◽

...

Keyword(s):

Gastrointestinal Tract ◽

Gastroesophageal Reflux Disease ◽

Gastric Mucosa ◽

Gastroesophageal Reflux ◽

Reflux Disease ◽

Erosive Esophagitis ◽

Control Group ◽

Esophageal Mucosa ◽

Gastric Evacuation ◽

Duodenogastroesophageal Reflux

The article identifies the features of the pathology of the gastrointestinal tract in patients with gastroesophageal reflux disease on the background of hypothyroidism. The frequency of gastroesophageal reflux disease and the severity of this disease increase with age and the presence of comorbid pathology. In the elderly, the frequency of the typical esophageal manifestations decreases, and the erosive esophagitis with atypical symptoms is more common. The growing number of cases of combined thyroid dysfunction with gastropathology requires in-depth study of the reasons for the relationship between these processes. Pathological changes in the gastrointestinal tract in these patients make their condition severer, contributing to the development and progression of metabolic disorders. An important aggravating effect on the regulatory mechanisms of esophageal kinetics has a pathological functioning of the thyroid gland on the background of iodine deficiency. Results and discussion. In patients with gastroesophageal reflux disease with hypothyroidism, all changes in gastric and duodenal function are associated with a decrease in the acid-forming function of the gastric mucosa, due to its atrophy, decreased tone and contractility of the stomach. This in turn leads to a slowing of gastric and duodenal evacuation, dysfunction of the closing capacity of the cardia and, as a consequence, the development of duodenogastroesophageal reflux. The esophageal contents are not so pronounced, so patients with non-erosive forms of esophagitis predominate (46.2%) against 16% of patients in the second group (patients with gastroesophageal reflux disease). At the same time, erosive forms predominate among patients in the control group with predominant acid reflux. It should be noted that there is a clear relationship between the frequency of erosive changes in the esophageal mucosa and the duration of the disease. Thus, among patients of the main group with a 5-year history of the disease, the number of erosive forms of gastroesophageal reflux disease was minimal. The number of erosive changes in the esophageal mucosa increased sharply in patients with a 10-year history and reached its maximum after 15 years from the onset of the disease. Conclusion. The delay in gastric evacuation is more pronounced in patients with gastroesophageal reflux disease on the background of hypothyroidism. It can be explained by a decrease in gastric motility and the presence of duodenostasis. The slowing of gastric evacuation was more pronounced in patients with gastroesophageal reflux disease on the background of reduced thyroid function. In patients with gastroesophageal reflux disease on the background of hypothyroidism there is an alkaline duodenogastroesophageal reflux as a consequence of reduced acid-forming function of the gastric mucosa and reduced contractility of the stomach and duodenum

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Short segment Barrett's esophagus and distal gastric intestinal metaplasia

Arquivos de Gastroenterologia ◽

10.1590/s0004-28032006000200011 ◽

2006 ◽

Vol 43 (2) ◽

pp. 117-120

Author(s):

Judite Dietz ◽

Sílvia Chaves-e-Silva ◽

Luíse Meurer ◽

Setsuo Sekine ◽

Andréa Ribeiro de Souza ◽

...

Keyword(s):

Gastroesophageal Reflux Disease ◽

Gastroesophageal Reflux ◽

Intestinal Metaplasia ◽

Barrett’S Esophagus ◽

Reflux Disease ◽

Barrett's Esophagus ◽

Short Segment ◽

Disease Symptoms ◽

Gastric Intestinal Metaplasia ◽

H Pylori

BACKGROUND: Short segment Barrett's esophagus is defined by the presence of <3 cm of columnar-appearing mucosa in the distal esophagus with intestinal metaplasia on histophatological examination. Barrett's esophagus is a risk factor to develop adenocarcinoma of the esophagus. While Barrett's esophagus develops as a result of chronic gastroesophageal reflux disease, intestinal metaplasia in the gastric cardia is a consequence of chronic Helicobacter pylori infection and is associated with distal gastric intestinal metaplasia. It can be difficult to determine whether short-segment columnar epithelium with intestinal metaplasia are lining the esophagus (a condition called short segment Barrett's esophagus) or the proximal stomach (a condition called intestinal metaplasia of the gastric cardia). AIMS: To study the association of short segment Barrett's esophagus (length <3 cm) with gastric intestinal metaplasia (antrum or body) and infection by H. pylori. PATIENTS AND METHODS: Eight-nine patients with short segment columnar-appearing mucosa in the esophagus, length <3 cm, were studied. Symptoms of gastroesophageal reflux disease were recorded. Biopsies were obtained immediately below the squamous-columnar lining, from gastric antrum and gastric corpus for investigation of intestinal metaplasia and H. pylori. RESULTS: Forty-two from 89 (47.2%) patients were diagnosed with esophageal intestinal metaplasia by histopathology. The mean-age was significantly higher in the group with esophageal intestinal metaplasia. The two groups were similar in terms of gender (male: female), gastroesophageal reflux disease symptoms and H. pylori infection. Gastric intestinal metaplasia (antrum or body) was diagnosed in 21 from 42 (50.0%) patients in the group with esophageal intestinal metaplasia and 7 from 47 (14.9%) patients in the group with esophageal columnar appearing mucosa but without intestinal metaplasia. CONCLUSION: Intestinal metaplasia is a frequent finding in patients with <3 cm of columnar-appearing mucosa in the distal esophagus. In the present study, short segment intestinal metaplasia in the esophagus is associated with distal gastric intestinal metaplasia. Gastroesophageal reflux disease symptoms and H. pylori infection did not differ among the two groups studied.

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