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Prevalence and determinants of histological abnormalities of the gastric cardia in volunteers.
Scand J Gastroenterol 2007; 42(10):1158-66SJ

Abstract

OBJECTIVE

The findings of studies examining the prevalence and major risk factors of histological abnormalities of the gastric cardia have been inconsistent. Selection bias was possible in these studies depending on whether patients were referred for ulcer or gastroesophageal reflux disease (GERD). There have been no studies on non-patient populations. The aim of this study was to mitigate the potential effects of selection bias.

MATERIAL AND METHODS

In a study comprising health-care workers, we distributed symptom questionnaires and invitations to undergo upper endoscopy. A single endoscopist performed standard endoscopy and biopsy examinations (2 antral, 2 corporal, and 2 cardiac biopsies). Staining was done using triple stain. Two pathologists, who were blinded to the results of the questionnaires and endoscopy, interpreted and recorded the histological findings.

RESULTS

A total of 226 participants underwent endoscopy. Gastric cardia, as defined by the presence of mucous glands, was identified in 191 subjects; mean age of the subjects was 45 years, 117 (61%) were women, and 49% were black. Active gastritis of the cardia was present in 58 (30.4%), chronic gastritis in 133 (69.6%), intestinal metaplasia (IM) in 29 (15.2%), and pancreatic metaplasia in 25 (13%). Direct (organisms) or indirect evidence (active anywhere or chronic gastritis in antrum or corpus) for Helicobacter pylori was present in all participants with active gastritis, 60% of subjects with chronic gastritis, and approximately half of those with IM of the cardia. Approximately 15% with chronic carditis had neither H. pylori nor GERD symptoms. There were also no significant differences in the prevalence of heartburn or acid regurgitation, or the use of histamine-2-receptor antagonists (H2RAs) or proton-pump inhibitors (PPIs) between groups with and without active or chronic gastritis, IM, or pancreatic metaplasia, whereas active or chronic gastritis in the antrum or corpus and H. pylori infection were more frequent (1.5- to 2-fold) among those with histological abnormalities of the cardia.

CONCLUSIONS

Active and chronic gastritis as well as intestinal metaplasia of the gastric cardia are relatively common in health-care worker volunteers. Although GERD symptoms are not significantly associated with these abnormalities, H. pylori infection is a strong risk factor. However, a considerable number of participants with chronic gastritis of the cardia have neither H. pylori nor GERD.

Authors+Show Affiliations

Section of Gastroenterology, Houston Department of Veterans Affairs Medical Center and Baylor College of Medicine, Houston, Texas, USA. hasheme@bcm.tmc.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17852849

Citation

El-Serag, Hashem B., et al. "Prevalence and Determinants of Histological Abnormalities of the Gastric Cardia in Volunteers." Scandinavian Journal of Gastroenterology, vol. 42, no. 10, 2007, pp. 1158-66.
El-Serag HB, Graham DY, Rabeneck L, et al. Prevalence and determinants of histological abnormalities of the gastric cardia in volunteers. Scand J Gastroenterol. 2007;42(10):1158-66.
El-Serag, H. B., Graham, D. Y., Rabeneck, L., Avid, A., Richardson, P., & Genta, R. M. (2007). Prevalence and determinants of histological abnormalities of the gastric cardia in volunteers. Scandinavian Journal of Gastroenterology, 42(10), pp. 1158-66.
El-Serag HB, et al. Prevalence and Determinants of Histological Abnormalities of the Gastric Cardia in Volunteers. Scand J Gastroenterol. 2007;42(10):1158-66. PubMed PMID: 17852849.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prevalence and determinants of histological abnormalities of the gastric cardia in volunteers. AU - El-Serag,Hashem B, AU - Graham,David Y, AU - Rabeneck,Linda, AU - Avid,Adjula, AU - Richardson,Peter, AU - Genta,Robert M, PY - 2007/9/14/pubmed PY - 2008/3/13/medline PY - 2007/9/14/entrez SP - 1158 EP - 66 JF - Scandinavian journal of gastroenterology JO - Scand. J. Gastroenterol. VL - 42 IS - 10 N2 - OBJECTIVE: The findings of studies examining the prevalence and major risk factors of histological abnormalities of the gastric cardia have been inconsistent. Selection bias was possible in these studies depending on whether patients were referred for ulcer or gastroesophageal reflux disease (GERD). There have been no studies on non-patient populations. The aim of this study was to mitigate the potential effects of selection bias. MATERIAL AND METHODS: In a study comprising health-care workers, we distributed symptom questionnaires and invitations to undergo upper endoscopy. A single endoscopist performed standard endoscopy and biopsy examinations (2 antral, 2 corporal, and 2 cardiac biopsies). Staining was done using triple stain. Two pathologists, who were blinded to the results of the questionnaires and endoscopy, interpreted and recorded the histological findings. RESULTS: A total of 226 participants underwent endoscopy. Gastric cardia, as defined by the presence of mucous glands, was identified in 191 subjects; mean age of the subjects was 45 years, 117 (61%) were women, and 49% were black. Active gastritis of the cardia was present in 58 (30.4%), chronic gastritis in 133 (69.6%), intestinal metaplasia (IM) in 29 (15.2%), and pancreatic metaplasia in 25 (13%). Direct (organisms) or indirect evidence (active anywhere or chronic gastritis in antrum or corpus) for Helicobacter pylori was present in all participants with active gastritis, 60% of subjects with chronic gastritis, and approximately half of those with IM of the cardia. Approximately 15% with chronic carditis had neither H. pylori nor GERD symptoms. There were also no significant differences in the prevalence of heartburn or acid regurgitation, or the use of histamine-2-receptor antagonists (H2RAs) or proton-pump inhibitors (PPIs) between groups with and without active or chronic gastritis, IM, or pancreatic metaplasia, whereas active or chronic gastritis in the antrum or corpus and H. pylori infection were more frequent (1.5- to 2-fold) among those with histological abnormalities of the cardia. CONCLUSIONS: Active and chronic gastritis as well as intestinal metaplasia of the gastric cardia are relatively common in health-care worker volunteers. Although GERD symptoms are not significantly associated with these abnormalities, H. pylori infection is a strong risk factor. However, a considerable number of participants with chronic gastritis of the cardia have neither H. pylori nor GERD. SN - 0036-5521 UR - https://www.unboundmedicine.com/medline/citation/17852849/Prevalence_and_determinants_of_histological_abnormalities_of_the_gastric_cardia_in_volunteers_ L2 - http://www.tandfonline.com/doi/full/10.1080/00365520701299915 DB - PRIME DP - Unbound Medicine ER -