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Features of chronic inflammation at the gastric cardia and the relationship with Helicobacter pylori infection and oesophagitis.
Acta Gastroenterol Belg 2003 Apr-Jun; 66(2):144-9AG

Abstract

BACKGROUND

The etiopathogenesis of chronic inflammation at the gastric cardia is still debated. It is suggested that carditis may be a finding of gastro-oesophageal reflux disease (GORD) or it may occur as a result of the gastritis caused by Helicobacter pylori (H. pylori) infection.

AIM

To examine morphological features of carditis, as well as the associations of carditis with Helicobacter pylori gastritis and oesophagitis as a marker of gastro-oesophageal reflux disease.

PATIENTS AND METHODS

Endoscopic biopsy specimens obtained systematically from oesophagus, cardia, corpus and antrum of 135 dyspeptic patients were retrospectively evaluated. In biopsies, we have searched for any correlations between clinical, endoscopic, and histological features.

RESULTS

Carditis was detected in 123 (91.1%) of the cases. The mean age of the carditis group was 47.9 years and the male-to-female ratio was 1.08:1. The relation of carditis with age and sex was not significant (p = 0.19 and p = 0.24, respectively). All cases of the carditis group had concomitant chronic gastritis. In these cases, chronic inflammation, degree of neutrophil-mediated activity and H. pylori colonisation were significantly correlated in cardia, corpus and antrum (p < 0.001). Intestinal metaplasia was observed in 14 cases (11.3%) and, was associated with H. pylori colonisation (p < 0.001). Microscopic oesophagitis detected in 37.7% cases also showed correlation with reflux symptoms and endoscopic oesophagitis but not carditis. When all cases with carditis were evaluated for H. pylori infection and oesophagitis, which are presumed risk factors for carditis, H. pylori infection appeared to be an independent risk factor for carditis (p = 0.012), while oesophagitis did not.

CONCLUSIONS

This study suggests that carditis is commonly found in patients presenting with dyspepsia and the histological features of carditis were similar to those seen in H. pylori gastritis in antrum and corpus. In addition, our data have also shown that carditis was significantly associated with H. pylori infection but not with symptoms or signs of GORD.

Authors+Show Affiliations

Celal Bayar University Faculty of Medicine, Department of Pathology, Manisa, Turkey. ayhan@egenet.com.trNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

12891923

Citation

Ayhan, Semin, et al. "Features of Chronic Inflammation at the Gastric Cardia and the Relationship With Helicobacter Pylori Infection and Oesophagitis." Acta Gastro-enterologica Belgica, vol. 66, no. 2, 2003, pp. 144-9.
Ayhan S, Demir MA, Kandiloglu AR, et al. Features of chronic inflammation at the gastric cardia and the relationship with Helicobacter pylori infection and oesophagitis. Acta Gastroenterol Belg. 2003;66(2):144-9.
Ayhan, S., Demir, M. A., Kandiloglu, A. R., Saruc, M., & Kucukmetin, N. (2003). Features of chronic inflammation at the gastric cardia and the relationship with Helicobacter pylori infection and oesophagitis. Acta Gastro-enterologica Belgica, 66(2), pp. 144-9.
Ayhan S, et al. Features of Chronic Inflammation at the Gastric Cardia and the Relationship With Helicobacter Pylori Infection and Oesophagitis. Acta Gastroenterol Belg. 2003;66(2):144-9. PubMed PMID: 12891923.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Features of chronic inflammation at the gastric cardia and the relationship with Helicobacter pylori infection and oesophagitis. AU - Ayhan,Semin, AU - Demir,Mehmet Akif, AU - Kandiloglu,Ali Riza, AU - Saruc,Murat, AU - Kucukmetin,Nurten, PY - 2003/8/2/pubmed PY - 2003/9/17/medline PY - 2003/8/2/entrez SP - 144 EP - 9 JF - Acta gastro-enterologica Belgica JO - Acta Gastroenterol. Belg. VL - 66 IS - 2 N2 - BACKGROUND: The etiopathogenesis of chronic inflammation at the gastric cardia is still debated. It is suggested that carditis may be a finding of gastro-oesophageal reflux disease (GORD) or it may occur as a result of the gastritis caused by Helicobacter pylori (H. pylori) infection. AIM: To examine morphological features of carditis, as well as the associations of carditis with Helicobacter pylori gastritis and oesophagitis as a marker of gastro-oesophageal reflux disease. PATIENTS AND METHODS: Endoscopic biopsy specimens obtained systematically from oesophagus, cardia, corpus and antrum of 135 dyspeptic patients were retrospectively evaluated. In biopsies, we have searched for any correlations between clinical, endoscopic, and histological features. RESULTS: Carditis was detected in 123 (91.1%) of the cases. The mean age of the carditis group was 47.9 years and the male-to-female ratio was 1.08:1. The relation of carditis with age and sex was not significant (p = 0.19 and p = 0.24, respectively). All cases of the carditis group had concomitant chronic gastritis. In these cases, chronic inflammation, degree of neutrophil-mediated activity and H. pylori colonisation were significantly correlated in cardia, corpus and antrum (p < 0.001). Intestinal metaplasia was observed in 14 cases (11.3%) and, was associated with H. pylori colonisation (p < 0.001). Microscopic oesophagitis detected in 37.7% cases also showed correlation with reflux symptoms and endoscopic oesophagitis but not carditis. When all cases with carditis were evaluated for H. pylori infection and oesophagitis, which are presumed risk factors for carditis, H. pylori infection appeared to be an independent risk factor for carditis (p = 0.012), while oesophagitis did not. CONCLUSIONS: This study suggests that carditis is commonly found in patients presenting with dyspepsia and the histological features of carditis were similar to those seen in H. pylori gastritis in antrum and corpus. In addition, our data have also shown that carditis was significantly associated with H. pylori infection but not with symptoms or signs of GORD. SN - 1784-3227 UR - https://www.unboundmedicine.com/medline/citation/12891923/Features_of_chronic_inflammation_at_the_gastric_cardia_and_the_relationship_with_Helicobacter_pylori_infection_and_oesophagitis_ L2 - https://medlineplus.gov/gerd.html DB - PRIME DP - Unbound Medicine ER -