Clinical analysis on bile reflux gastritis in children

Abstract

Objective To compare the clinical symptoms,endoscopic lesions,pathological histological changes,and H.pylori infection between children with bile reflux gastritis (BRG) and non BRG.Methods 287 cases of children with upper gastrointestinal symptoms were diagnosed with gastritis by gastroscopy.They included 58 cases of BRG and 229 cases of non-BRG.The clinical symptoms,endoscopic lesions,pathological histological changes,and H.pylori infection were compared between two groups,respectively.Results Between BRG and non-BRG groups,there werent statistically significant difference in the main clinical symptoms including abdominal pain,anorexia,nausea,and early satiety.Incidence of abdominal distension,vomiting,and hiccups was[84.5％ (49/58) vs 66.8％ (153/229),32.8％ (19/58) vs 17.9％ (41/229),and 29.3％ (17/58) vs 16.6％ (38/229)],respectively,with statistical significance (x2 =6.93,6.18,4.83,P ＜0.05).There weren(t) statistically significant difference in endoscopic lesions congestion,edema,and mucosal plaques between two groups.Incidence of endoscopic gastric erosions and bleeding of two groups was [37.9％ (22/58) vs 22.7％ (52/229),20.7％ (12/58) vs 10.0％ (23/ 229)],respectively; and BRG group was statistically higher than non-BRG group(x2 =5.60,4.90,P ＜ 0.05).For micronodular change,there were 13 cases (22.4％) in BRG group and 86 cases (37.6％) in Non-BRG group,and Non-BRG group was statistically higher than BRG group(x2 =4.69,P ＜ 0.05).For histopathological changes including epithelial cell degeneration,hyperplasia and lamina propria lymphocyte and neutrophil infiltration,there wasnt statistically significant difference between BRG and non-BRG groups.Incidence about pit extension and mucosal vascular expansion of two groups was [10.34％ (6/58) vs 3.1％ (7/229) and 31.0 ％ (18/58) vs 18.3 ％ (42/229)],respectively ; and BRG group was significantly higher than non-BRG group(x2 =5.97,4.51,P ＜ 0.05).There were 7 cases (12.1％) in BRG group and 55 cases (24.0％) about lamina propria lymphoid follicles,and Non-BRG group was significantly higher than BRG group (x2 =3.90,P ＜0.05).H.pylori positive rates were[22.41％ (13/58),and 40.17％ (92/ 229)],respectively.BRG group and non-BRG group were found statistically significant (x2 =6.29,P ＜0.05).Conclusions BRG children with the characteristic symptoms were abdominal distension,vomiting,and hiccup inverse.Endoscopic characteristic performance was gastric erosions,bleeding spots in antral mucosa changes apparently.Mucosal vascular expansion and pit extension may prompt gastric in children with duodenogastric reflux.H.pylori positive rates of those gastric in children with bile reflux were relatively low.The clinical features could help early diagnosis BRG and guide clinical treatment to improve the cure rate. Key words: Bile reflux; Gastritis/etiology; Child