Prevalence Of Chronic Atrophic Gastritis Research Articles

Effects of aging and gastritis on gastric acid and pepsin secretion in humans: A prospective study

BACKGROUND & AIMS: Recent studies suggesting that gastric secretion does not decrease with aging included few elderly individuals and measured only acid secretion. The aims of this study were to measure gastric acid and pepsin output in 206 health Americans (age range, 18- 98 years) and to compare secretion rates with gastric histology. METHODS: Immediately after basal and pentagastrin-stimulated acid and pepsin outputs were measured, oxyntic biopsy samples were obtained. RESULTS: Gastric acid and pepsin output rates were similar in young (age range, 18-34 years) and middle-aged (age range, 35-64 years) groups. Stimulated acid output was reduced approximately 30% in the elderly (age range, 65-98 years). However, after adjustment for histology, Helicobacter pylori infection, and other variables, age had no independent effect on acid output. The decline in acid secretion in the elderly was primarily related to a higher prevalence of chronic atrophic gastritis and a lower prevalence of smoking. Pepsin output was reduced by approximately 40% in the elderly. After adjustment for other variables, age remained a robust predictor of reduced pepsin output. CONCLUSION: Although advancing age has no independent effect on gastric acid secretion, it is associated with reduced pepsin output independent of atrophic gastritis, H. pylori infection, and smoking. (Gastroenterology 1996 Apr;110(4):1043-52)

Prevalence of Helicobacter pylori infection and gastritis among young adults in China

To investigate the prevalence of gastritis and H. pylori infection among young Chinese in Henan Province, a high incidence area for oesophageal cancer in China, the gastric mucosa was examined in 194 asymptomatic subjects, aged 15-26 years, in the course of an epidemiological study of precursor lesions of oesophageal cancer. Histopathological grading of gastritis and determination of H. pylori infection were performed on haematoxylineosin and Warthin-Starry stained section. An enzyme-linked immunosorbent assay was used to detect the presence of serum IgG antibodies to H. pylori. A very high prevalence of gastritis (93.8%) was found: 71 subjects (36.6%) presented with superficial gastritis (14 active), 94 (48.5%) with diffuse gastritis (92 active) and in 17 cases (8.8%) diffuse gastritis (16 active) was accompanied by focal atrophy. Silver staining detected H. pylori in 166 (85.6%) of the study participants. However, serological techniques identified H. pylori in only 109 (56.2%). H. pylori was seen in all the 119 cases showing histological signs of active gastritis, in 41 of the 63 cases (65%) without activity, and also in 50% (6/12) of histologically normal subjects. H. pylori infection was found to be associated with a 2.5-fold higher prevalence of chronic atrophic gastritis compared with non-atrophic gastritis. A family history of stomach cancer, consumption of pickled vegetables more than twice a month, and a high monthly salt consumption (> 500 g/month) also showed a positive association.(ABSTRACT TRUNCATED AT 250 WORDS)

Characteristics of the gastric mucosa of direct relatives of patients with sporadic gastric carcinoma

We compared the gastric mucosa lesions of 63 direct relatives of 24 patients with gastric carcinoma with those observed in 151 dyspeptic patients and in seven members of a family with familial gastric carcinoma of diffuse type. We found a higher prevalence of Helicobacter pylori infection (96.8%) and gastritis (98.4%) in the relatives of patients with sporadic carcinoma than in the dyspeptic patients. One-third of the individuals of the former group displayed chronic atrophic gastritis and intestinal metaplasia. Dysplasia was only observed in the group of cancer patient relatives. The relatives of patients with intestinal carcinoma showed a higher prevalence of chronic atrophic gastritis (40.0%), incomplete intestinal metaplasia (22.9%) and dysplasia (5.7%) than the relatives of patients with diffuse carcinoma (10.0%, 0.0% and 0.0%, respectively). The only striking feature that emerged from the comparison of relatives of patients with sporadic gastric carcinoma with the members of the family with familial gastric carcinoma was the significantly higher prevalence of hyperplastic lesions (100%) in the latter group. These results reinforce the existence of two main pathways of carcinogenesis of gastric mucosa, one leading to intestinal carcinoma via chronic atrophic gastritis and intestinal metaplasia and the other leading to diffuse carcinoma via hyperplastic changes.

Gastric cancer in Colombia. I. Cancer risk and suspect environmental agents.

A case control study of patients discharged from hospitals revealed fourfold differences in geographic variation in stomach cancer risk within the Department of Narino (Colombia). Data from gastroscopic surveys of population groups, samples of water supplies, and urine and saliva in Narino also indicated a generally positive correlation among the following parameters: 1) gastric cancer risk, 2) prevalence of chronic atrophic gastritis and intestinal metaplasia, 3) nitrate content of well waters, and 4) nitrate excretion by the population. Urinary excretion reflected the ingestion of nitrates, and this implied a higher average intake of nitrates in the populations at high risk for stomach cancer. The Narino data could be construed as presumptive epidemiologic evidence for the role of nitrate availability in the etiology of stomach cancer.