Abstract
ABSTRACTBackground:Morbid obesity is a multifactorial disease that increasingly is being treated by surgery. Aim: To evaluate gastric histopathological changes in obese, and to compare with patients who underwent gastrojejunal bypass and the jejunal mucosa after the surgery. Methods:This is an observational study performed at a tertiary public hospital, evaluating endoscopic biopsies from 36 preoperative patients and 35 postoperative. Results:In the preoperative group, 80.6% had chronic gastritis, which was active in 38.9% (77.1% and 20.1%, respectively, in the postoperative). The postoperative group had a significant reduction in H. pylori infection (p=0.0001). A longer length of the gastric stump and a time since surgery of more than two years were associated with Helicobacter pylori infection. The jejunal mucosa was normal in 91.4% and showed slight nonspecific chronic inflammation in 8.6%. Conclusion:There was a reduction in the incidence of Helicobacter pylori infection in the postoperative group. A longer length of the gastric stump and longer time elapsed since surgery were associated with Helicobacter pylori infection. The jejunal mucosa was considered normal in an absolute majority of patients.
Highlights
Obesity is a chronic disease characterized by excessive accumulation of adipose tissue in the organism
Gastritis, and Helicobacter pylori (HP) infection are not necessarily associated, studies suggest that HP infection can affect food consumption through ghrelin, a peptide secreted in the stomach
Our findings indicated no association between HP infection and higher BMI in postoperative group
Summary
Obesity is a chronic disease characterized by excessive accumulation of adipose tissue in the organism. This disease has increased in prevalence in recent decades, in developing countries, and the levels have nearly doubled between 1980 and 20146, 10, 28. Conventional treatment for morbid obesity produces unsatisfactory results, with around 95% of patients regain to their initial weight within two years of treatment. Despite the increased performance of bariatric surgery in recent years, few studies have investigated the histologic changes in the gastric mucosa of obese patients before surgery and in the mucosa of the Roux-en-Y anastomosis after surgery[1,22,24]. The objectives of this study were to evaluate histopathologic changes to the gastric mucosa in obese patients who were about to undergo bariatric surgery, and to compare these changes to the gastric and jejunal changes found in patients who had undergone surgery at least one year earlier
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