41 research outputs found
Early relapse of Gerd symptoms in patients with persistent histological findings of esophagitis
31 P Correlation between the segment length of Barrett's esophagus and the size of hiatal hernia: A mistake?
23 P Gastric metaplasia of duodenal bulb mucosa as a risk factor for developping esophagitis after eradication of helicobacter pylori infection in patients with hiatal hernia
Distinct profiles of gastritis in dyspepsia subgroups. Their different clinical responsens to gastritis healing after Helicobacter pylori eradication
Morphological evidence of Campylobacter pylori pathogenicity in chronic gastritis and peptic ulcer.
Analysis of Gastroduodenitis and Oesophagitis in Relation to Analysis of Gastroduodenitis and Oesophagitis in Relation to Dyspeptic/Reflux Symptoms.
BACKGROUND/AIMS: The pathogenesis of dyspeptic/reflux symptoms and the clinico-pathologic profile of affected patients are still poorly understood. To improve our knowledge in this field we carried out a systematic, comparative analysis of symptom profiles and histopathologic patterns of oesophagogastroduodenal mucosa in a series of 221 subjects, 140 with and 81 without endoscopic evidence of hiatal hernia. Of these, 190 showed reflux and/or dyspeptic symptoms.
METHODS: Before endoscopy, all the subjects were questioned about the presence and severity of 12 individual symptoms. Biopsies were taken from the distal oesophagus, cardia, corpus, angulus, antrum and duodenal bulb, and were scored in accordance with the Sydney system.
RESULTS: Patient groups with a distinct clinico-pathologic profile were better identified when symptoms of adequate severity were compared with histopathologic parameters. A correlation between gastroesophageal reflux disease (GORD) symptoms and histologic signs of oesophagitis was mostly restricted to patients endoscopically positive for oesophagitis. Retroxiphoid pyrosis correlated with cardial gastritis but not with oesophagitis, either endoscopic or histologic, while ulcer-like epigastric pain correlated with active duodenitis and distal gastritis. No definite histopathologic background was detected in patients with putative dysmotility-like symptoms, endoscopy-negative GORD and low score or mixed symptoms.
CONCLUSION: A contribution of Helicobacter pylori gastroduodenitis to the pathogenesis of some dyspeptic symptoms seems likely. However, the identification of specific histologic changes causing individual symptoms remains rather elusive, with the exception of active antroduodenitis in patients with ulcer-like pain and of active proximal gastritis in patients with severe retroxiphoid pyrosis