Tags

Type your tag names separated by a space and hit enter

Inflammation of the gastro-oesophageal junction (carditis) in patients with symptomatic gastro-oesophageal reflux disease: a prospective study.
Gut 1999; 45(4):484-8Gut

Abstract

BACKGROUND

Recent data have suggested that cardia biopsy specimens may be more reflective of gastro-oesophageal reflux disease (GORD) than squamous biopsy specimens.

AIMS

To assess the distribution, severity, and types of mucosal injury in GORD.

PATIENTS

Thirty patients with symptomatic GORD with no or minimal erosions.

METHODS

Biopsies were performed at the squamocolumnar junction (Z-line) and 1-2 cm below the Z-line. Injury to the columnar mucosa was scored for inflammatory cells, epithelial cell abnormalities, and for the presence of intestinal metaplasia and Helicobacter pylori. A carditis score above 2 was considered positive (maximum score = 9).

RESULTS

Mean carditis scores and percentages of patients with a positive carditis score were higher in Z-line biopsy specimens containing both squamous and columnar mucosa than in those with just columnar mucosa or in specimens taken 1-2 cm below the Z-line. Carditis at the Z-line was focal in 49% of the specimens and was always present adjacent to the squamous epithelium. Goblet cells were present more frequently in the specimens immediately at the Z-line than in those 1-2 cm below the Z-line. H pylori was present in only four patients. The mean carditis scores of specimens 1-2 cm below the Z-line in these patients was significantly higher than in those patients without H pylori.

CONCLUSIONS

Mucosal injury at the gastric cardia is highly localised to the region adjacent to the squamocolumnar junction in patients with GORD. Morphological studies of the cardia in GORD should focus on tissue samples that contain both squamous and columnar epithelium in order to obtain an accurate picture of the spectrum of injury.

Authors+Show Affiliations

Department of Medicine, Division of Digestive Diseases and Gastroenterology, UCLA Medical Centre and Beth Israel Deaconess Medical Centre, Los Angeles, California, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

10486352

Citation

Lembo, T, et al. "Inflammation of the Gastro-oesophageal Junction (carditis) in Patients With Symptomatic Gastro-oesophageal Reflux Disease: a Prospective Study." Gut, vol. 45, no. 4, 1999, pp. 484-8.
Lembo T, Ippoliti AF, Ramers C, et al. Inflammation of the gastro-oesophageal junction (carditis) in patients with symptomatic gastro-oesophageal reflux disease: a prospective study. Gut. 1999;45(4):484-8.
Lembo, T., Ippoliti, A. F., Ramers, C., & Weinstein, W. M. (1999). Inflammation of the gastro-oesophageal junction (carditis) in patients with symptomatic gastro-oesophageal reflux disease: a prospective study. Gut, 45(4), pp. 484-8.
Lembo T, et al. Inflammation of the Gastro-oesophageal Junction (carditis) in Patients With Symptomatic Gastro-oesophageal Reflux Disease: a Prospective Study. Gut. 1999;45(4):484-8. PubMed PMID: 10486352.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Inflammation of the gastro-oesophageal junction (carditis) in patients with symptomatic gastro-oesophageal reflux disease: a prospective study. AU - Lembo,T, AU - Ippoliti,A F, AU - Ramers,C, AU - Weinstein,W M, PY - 1999/9/16/pubmed PY - 1999/9/16/medline PY - 1999/9/16/entrez SP - 484 EP - 8 JF - Gut JO - Gut VL - 45 IS - 4 N2 - BACKGROUND: Recent data have suggested that cardia biopsy specimens may be more reflective of gastro-oesophageal reflux disease (GORD) than squamous biopsy specimens. AIMS: To assess the distribution, severity, and types of mucosal injury in GORD. PATIENTS: Thirty patients with symptomatic GORD with no or minimal erosions. METHODS: Biopsies were performed at the squamocolumnar junction (Z-line) and 1-2 cm below the Z-line. Injury to the columnar mucosa was scored for inflammatory cells, epithelial cell abnormalities, and for the presence of intestinal metaplasia and Helicobacter pylori. A carditis score above 2 was considered positive (maximum score = 9). RESULTS: Mean carditis scores and percentages of patients with a positive carditis score were higher in Z-line biopsy specimens containing both squamous and columnar mucosa than in those with just columnar mucosa or in specimens taken 1-2 cm below the Z-line. Carditis at the Z-line was focal in 49% of the specimens and was always present adjacent to the squamous epithelium. Goblet cells were present more frequently in the specimens immediately at the Z-line than in those 1-2 cm below the Z-line. H pylori was present in only four patients. The mean carditis scores of specimens 1-2 cm below the Z-line in these patients was significantly higher than in those patients without H pylori. CONCLUSIONS: Mucosal injury at the gastric cardia is highly localised to the region adjacent to the squamocolumnar junction in patients with GORD. Morphological studies of the cardia in GORD should focus on tissue samples that contain both squamous and columnar epithelium in order to obtain an accurate picture of the spectrum of injury. SN - 0017-5749 UR - https://www.unboundmedicine.com/medline/citation/10486352/Inflammation_of_the_gastro_oesophageal_junction__carditis__in_patients_with_symptomatic_gastro_oesophageal_reflux_disease:_a_prospective_study_ L2 - http://gut.bmj.com/cgi/pmidlookup?view=long&pmid=10486352 DB - PRIME DP - Unbound Medicine ER -