Abstract
Introduction: Diseases related to gastric acid account for nearly one third of all health expenditure on gastrointestinal (GI) diseases. Evaluation of morphological features in chronic gastritis using updated Sydney system has not been systematically evaluated in India. So this study was done to interpret the histopathological changes in chronic gastritis using updated Sydney system and to correlate these pathological features with Helicobacter pylori (H. pylori) infection. Methods Gastric mucosal biopsies in a tertiary care centre in north India were evaluated using routine histopathological methods. Histopathological changes in patients with chronic gastritis were interpreted using updated Sydney system and correlated with H. pylori infection. Results: Chronic gastritis was seen in 89 cases. Histological grading of chronic gastritis was done by updated Sydney system. Chronic inflammation was present in 100% cases, neutrophilic activity in 39.33% cases, intestinal metaplasia in 7.87% cases, glandular atrophy in 12.36% cases and lymphoid follicles in 29.21% cases. H. pylori were identified in 50.56% cases of chronic gastritis. Association of H. pylori with pathological features in chronic gastritis was evaluated. The association of H. pylori with degree of chronic inflammation, neutrophilic activity and lymphoid aggregates was statistically significant. Conclusions: Histopathology should be performed in all cases of chronic gastritis. The updated Sydney classification provides an objective histological evaluation of chronic gastritis. The grade of chronic inflammation, neutrophilic activity and lymphoid follicles are significantly associated with H. pylori infection. So search for H. pylori should be initiated if neutrophils and lymphoid follicles are seen in the antral biopsies.
Highlights
Diseases related to gastric acid account for nearly one third of all health expenditure on gastrointestinal (GI) diseases
The biopsies were analysed taking into consideration the various histological parameters such as chronic inflammatory infiltrate, inflammatory activity, glandular atrophy, intestinal metaplasia, H. pylori and presence of lymphoid follicles
There were 56 males and 33 female patients with an M: F ratio of 1.7: 1. Histological grading of chronic gastritis was done by updated Sydney system [8] (Table 2)
Summary
Diseases related to gastric acid account for nearly one third of all health expenditure on gastrointestinal (GI) diseases. Evaluation of morphological features in chronic gastritis using updated Sydney system has not been systematically evaluated in India. This study was done to interpret the histopathological changes in chronic gastritis using updated Sydney system and to correlate these pathological features with Helicobacter pylori (H. pylori) infection. Disorders of the stomach are a frequent cause of clinical disease, with inflammatory and neoplastic lesions being common. Diseases related to gastric acid account for nearly one third of all health care spending on gastrointestinal (GI) diseases. Symptomatology of gastric diseases range from dyspepsia to altered bowel. Patients presenting with dyspepsia are often subjected to upper GI endoscopy as the first line of investigation.
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