The Prevalence of Gastritis and Delayed Gastric Emptying in Asymptomatic Volunteers

Abstract

Background: chronic gastric mucosal inflammation is closely associated with postprandial antral hypomotility. Antral hypomotility producing gastric stasis and pyloric sphincter abnormalities resulting in duodenogastric reflux of biliary-pancreatic secretions. The interactions among mucosal inflammation, alter motor activity and changes in gastric luminal milieu in asymptomatic gastric disease have not been investigated. We investigated 1) the prevalence of chronic antral gastritis in asymptomatic volunteers; 2) the correlation between the severity of antral mucosa damage and the gastric emptying of solids; and 3) ascertained the effects of a prokinetic drug (metoclopramide) on gastric motility.Methods: In 64 volunteers biopsy specimens were taken from the antrum. The endoscopic biopsy specimens were taken from the proximal and distal margins of the antrum. The gastric emptying of solids was analyzed by dualphase mode consisting of a lag phase and an emptying phase.Results: Endoscopically evident gastritis was present in 65.6%(42/64), histological gastritis in 78%(46/59). There were significant differences in gastric emptying between normals and those with histological evidence of gastritis (63±9 min vs. 88±6.5 min, P＜0.01) but not endoscopic gastritis. Histological gastritis correlated the best with delay in gastric emptying 93%(14/15). The lag duration was shortened by metoclopramide in the chronic superficial gastritis group. The emptying rate could be normalized by metoclopramide in the chronic gastritis group(superficial & atrophic).Conclusions: Gastric emptying correlated strongly with the presence or absence of histological gastritis. The degree of delayed gastric emptying correlated with the degree of gastritis. Metoclopramide may improve the gastric emptying phase and decrease the lag duration in superficial chronic gastritis patients but not in normal subjects.