Signs Of Gastritis Research Articles

Ultrasound evaluation of visceral fat and posture: relevance for diagnosis metabolic syndrome and obesity

Introduction Meeting definition of metabolic syndrome (MetS) requires detection of central obesity (increasing waist circumference, WC) plus any two of the other four factors (hyperglycemia, dyslipidemia, cardiovascular disease, hypertension) [1]. Multiparameter ultrasound (US) can provide accurate information on every MetS sign [2]. The Aim was to evaluate the relevance of measurement of visceral fat and posture and detecting metabolic health markers using US for diagnosis MetS and stratification overweight patients. Materials and Methods We included 120 overweight subjects (age 24-76 years; 65 females), BMI > 30, waist circumference (WC) > 110. 30 healthy volunteers were controls. All patients underwent general clinical, lab tests; abdominal US using convex 2-7 MHz probes was carried out to all patients including multiparameter US of liver, bile ducts, measuring shear wave elastography (SWE). We determined fat accumulations measuring VF and subcutaneous (SF) fat thickness (cm) and areas (cm2) on US and measured postural stability parameter (abdominal wall, diaphragm and pelvic floor motility); cardia structure (GERD signs) using dynamic US. We also included to the protocol measurements of liver, spleen and pancreas size and structure, the diameters of bile ducts; visualizing colon (anti)peristalsis; detection US signs of gastritis, nephropathy when appropriate. Results SF was 33 ± 7 mm, VF was 26 ± 6 mm (p 0.85). Higher incidence of hypertension (in 62 %); hypercholesterolemia (in 45 %); hyperuricemia (in 28 %); hyperglycemia (in 32 %); nephropathy (in 37 %), portal hypertension (in 32 %) was in obese individuals (p Conclusion Multiparameter abdominal US markers including evaluation of visceral fat and posture are robust and accessible markers to measure metabolic disease in obese patients, can be more reliable vs anthropometric data to define MetS.

Accuracy of different rapid urease tests in comparison with histopathology in patients with morphological signs of gastritis in endoscopy

Accuracy of different rapid urease tests in comparison with histopathology in patients with morphological signs of gastritis in endoscopy

Relationship of gastroscopic features to histological findings in gastritis and Helicobacter pylori infection in a general population sample.

Various gastroscopic features may be interpreted as signs of gastritis, but the significance of such features in relation to histomorphology is uncertain. The aim of this study was to determine how macroscopic findings were related to histomorphological changes and the presence of Helicobacter pylori in the gastric mucosa, in a sample of the general population. 488 adult individuals, randomly selected from a general population, were screened with gastroscopy and biopsy. The macroscopic features recorded were erythema (diffuse, spotty, linear), erosions, absence of rugae in the gastric corpus, and presence of visible vessels. Gastritis was classified microscopically according to the Sydney system. The presence of H. pylori was determined histologically and using the urease test on fresh biopsy specimens. The sensitivity and specificity of absence of rugae for moderate to severe atrophic gastritis in the gastric corpus were 67 % and 85 %, respectively. Corresponding values for severe atrophy were 90 % and 84 %. The sensitivity and specificity of the presence of visible vessels for moderate to severe atrophy in the corpus were 48 % and 87 %, and for severe atrophy the values were 80 % and 87 %, respectively. Considering the antrum, the sensitivity and specificity of the presence of visible vessels for moderate to severe atrophy was 14 % and 91 %, respectively. With regard to chronic inflammation (moderate to severe in the corpus or antrum), none of the features, alone or in combination, showed a sensitivity of more than 56 %. No endoscopic features (alone or in combination) showed a sensitivity of more than 57 % for H. pylori infection. Except for the absence of rugae and visible vessels in the gastric corpus, macroscopic features as observed during gastroscopy are of very limited value in the evaluation of whether or not gastritis or H. pylori infection are present. This is in accordance with most previous studies in patient populations, and it must be emphasized that the diagnosis of gastritis should be based on histological examination of the gastric mucosa.

Characteristics of intestinal metaplasia in the gastric cardia

OBJECTIVE: Intestinal metaplasia of the gastroesophageal junction is frequently grouped together with Barrett’s esophagus. The area of the gastroesophageal junction is comprised of the distal esophagus and the gastric cardia. The aim of the present study was to assess whether intestinal metaplasia in the distal esophagus and gastric cardia represent two different entities with a different set of risk factors. METHODS: Patients presenting for elective upper endoscopy were enrolled into a prospective study. The presence of gastritis and intestinal metaplasia was evaluated in gastric biopsies taken from the antrum, corpus, and cardia. Barrett’s esophagus was defined by the presence of any length of columnar mucosa above the gastroesophageal junction. RESULTS: Of 302 patients, 50 patients had intestinal metaplasia of the gastric cardia, 73 Barrett’s esophagus, and 116 erosive esophagitis. Men were more prone than women to develop Barrett’s esophagus or erosive esophagitis. Both conditions were also more common among whites than nonwhites. Smoking was particularly common among patients with Barrett’s esophagus. Patients with cardiac intestinal metaplasia did not share these demographic characteristics. The prevalence of daily reflux symptoms, erosive esophagitis, and Barrett’s esophagus was similar among patients both with and without cardiac intestinal metaplasia. However, atrophy and intestinal metaplasia of the gastric antrum and corpus were found more frequently among patients with than without cardiac intestinal metaplasia. CONCLUSIONS: Intestinal metaplasia of the gastric cardia is different from Barrett’s esophagus. Although cardiac intestinal metaplasia is closely associated with signs of gastritis in other parts of the stomach, gastroesophageal reflux disease does not seem to be a risk factor. A diagnosis of Barrett’s esophagus should not be made based on the presence of intestinal metaplasia within the cardiac portion of the gastroesophageal junction.

Characteristics of intestinal metaplasia in the gastric cardia.

Intestinal metaplasia of the gastroesophageal junction is frequently grouped together with Barrett's esophagus. The area of the gastroesophageal junction is comprised of the distal esophagus and the gastric cardia. The aim of the present study was to assess whether intestinal metaplasia in the distal esophagus and gastric cardia represent two different entities with a different set of risk factors. Patients presenting for elective upper endoscopy were enrolled into a prospective study. The presence of gastritis and intestinal metaplasia was evaluated in gastric biopsies taken from the antrum, corpus, and cardia. Barrett's esophagus was defined by the presence of any length of columnar mucosa above the gastroesophageal junction. Of 302 patients, 50 patients had intestinal metaplasia of the gastric cardia, 73 Barrett's esophagus, and 116 erosive esophagitis. Men were more prone than women to develop Barrett's esophagus or erosive esophagitis. Both conditions were also more common among whites than nonwhites. Smoking was particularly common among patients with Barrett's esophagus. Patients with cardiac intestinal metaplasia did not share these demographic characteristics. The prevalence of daily reflux symptoms, erosive esophagitis, and Barrett's esophagus was similar among patients both with and without cardiac intestinal metaplasia. However, atrophy and intestinal metaplasia of the gastric antrum and corpus were found more frequently among patients with than without cardiac intestinal metaplasia. Intestinal metaplasia of the gastric cardia is different from Barrett's esophagus. Although cardiac intestinal metaplasia is closely associated with signs of gastritis in other parts of the stomach, gastroesophageal reflux disease does not seem to be a risk factor. A diagnosis of Barrett's esophagus should not be made based on the presence of intestinal metaplasia within the cardiac portion of the gastroesophageal junction.

Detection and effects of Helicobacters in healthy dogs and dogs with signs of gastritis

Objectives To determine prevalence, colonization density, and distribution of helicobacters and gastric histologic findings in healthy dogs and dogs with signs of gastritis; to evaluate association of colonization density and gastric inflammation; and to compare the number of Helicobacter spp with degree of inflammation. Design Cross-sectional prevalence survey. Animals 25 healthy dogs and 21 dogs with signs of gastritis. Procedure During endoscopy, gastric mucosal biopsy specimens were obtained from healthy and affected client-owned dogs. Histologic and cytologic evaluation and results of a urease test were used for detecting helicobacters, which were identified definitively by use of transmission electron microscopy and bacterial culture. Results Helicobacters were detected in all 25 healthy and 20 of 21 affected dogs. Cytologic examination was a more sensitive method than histologic examination or the urease test. Helicobacters were found least frequently and in fewest number in the antrum in both groups of dogs. Gastric inflammation was evident in both groups of dogs and did not differ significantly between groups. A significant association was not detected between colonization density or the number of Helicobacter spp and degree of gastric inflammation. In both groups, H bizzozeronii, H felis, and H salomonis were cultured. Clinical Implications Histologically verified chronic gastritis is common in dogs with signs of gastritis as well as in healthy dogs. Colonization density of helicobacters was not associated with degree of gastric inflammation in the dogs of our study. It remains to be determined whether certain strains of Helicobacter spp can induce gastritis in dogs. (J Am Vet Med Assoc 1998;213:1767–1774)

Mucosal bacterial growth in the upper gastrointestinal tract in alcoholics (heavy drinkers).

Mucosal adherent bacterial flora in chronic alcoholics was studied and compared to a control group referred for upper endoscopy, mainly for dyspepsia. 22 alcoholics, admitted to hospital for detoxification, were examined using upper gastrointestinal endoscopy. Gastric and duodenal biopsies were taken for tissue pathology, quantitative and qualitative anaerobic and aerobic bacteriological culture and for culture of Helicobacter pylori (antral biopsies). 12 nonalcoholics, admitted for upper endoscopy mainly for dyspepsia, were chosen as a control group. Seven of these had used gastric acid inhibitors. Gastrointestinal symptoms were common among alcoholics: 20/22 (90%) had diarrhea, nausea and/or abdominal pain. There were signs of gastritis by endoscopy in 64% of the alcoholics and in 58% of the controls. Tissue pathology, however, showed active chronic antral gastritis in 27% of the alcoholics and in 42% of the controls. H. pylori were isolated in 7/22 of the alcoholics and in 4/12 of the controls, which corresponds to the mean prevalence for these age groups in Sweden. Significantly more bacteria, dominated by gram-positive aerobic cocci, were present in the gastric biopsies of alcoholics than in those of controls (mean of 2.9 x 10(6)/g material versus 4.4 x 10(5), p < 0.05). There were 2.6 times more bacteria in the duodenal biopsies of alcoholics than in those of the controls (p > 0.05, NS). Bacterial overgrowth (defined as >2 x 10(3) organisms/g material) was found in the stomach in 20/22 (90%) alcoholics and in 6/12 (50%) controls (p < 0.01). Alcoholics have an increased frequency of bacterial overgrowth in the upper gastrointestinal tract. This may contribute to the common gastrointestinal symptoms.

Frequency ofHelicobacter pyloriand Gastritis in Healthy Subjects without Gastrointestinal Symptoms

To investigate the frequency of Helicobacter pylori and gastritis in asymptomatic adults, 30 healthy volunteers underwent upper endoscopy. Biopsy specimens were obtained from the corporeal and antral mucosa of the stomach. The specimens were examined by light microscopy for gastritis and the occurrence of H. pylori. In 12 subjects signs of gastritis were noted at endoscopy, but only in 7 of them was this diagnosis confirmed histologically. No other abnormalities were observed by the endoscopist. Histologic examination was normal in 17 subjects, but in 13 subjects (43%) inflammation was found in the gastric specimens. Ten had inflammation both in the corpus and in the prepyloric specimens, and in six of these subjects H. pylori was discovered. H. pylori was only found in subjects with inflammation in both the corpus and the antrum. Subjects with gastritis were slightly older than subjects with normal gastric mucosa (median age, 47 versus 37 years; not significant). In the group of subjects with gastritis, persons with H. pylori were older than those without (median age, 53.5 versus 36 years; p = 0.05). The results of our study indicate that gastritis is present before colonization with H. pylori occurs. This could imply that H. pylori is not the cause of gastritis but that the presence of gastritis is a prerequisite for colonization of the bacterium in the stomach.

Duodenogastric reflux in the dog, a clinicopathological study

In an experimental group of dogs which included seven clinically healthy dogs and 34 dogs with symptoms of (upper) gastrointestinal disease, nine dogs had endoscopic signs of duodenogastric reflux and 13 dogs had a positive duodenogastric reflux test. Endoscopic examination and the reflux test were in agreement in seven dogs (dogs with duodenogastric reflux) but not in eight dogs (dogs with potential duodenogastric reflux). Examination of dogs with duodenogastric reflux showed bile stained gastric material; thick red rugal folds; petechia in the antral mucosa in three dogs; five dogs with histological signs of gastritis; four dogs with signs of enteritis; four with gastric acid hyposecretion and four with a delayed gastric emptying. Two dogs with potential duodenogastric reflux had endoscopic reflux gastritis; three dogs had histological gastritis and seven enteritis. The present study indicates that excessive duodenogastric reflux is likely to play a role in the pathogenesis of canine gastritis.

Chronic gastritis; a review of the literature.

A more appropriate title for this paper would be “A Reconnaissance of the Literature Concerning Chronic Gastritis,” as my purpose is to summarize the thoughts of the medical world on the subject. One has merely to thumb through the references Schindler used in his book on Gastritis to realize that volumes have been written about the disease, and years would be necessary to study and to put down accurately on paper the numerous facts and thoughts. Whenever volumes are written on any medical subject, one knows that it is a controversial one and that the facts are less numerous than the thoughts. This is most certainly true of gastritis, as the pathologists are not agreed among themselves, let alone in accord with the radiologists or the gastroscopists or the surgeons or the internists, among whom there are also at least two schools of thought. It may be that on this subject medicine must forsake as leaders or as authorities the anatomists and pathologists and turn to the physiologists for new criteria and yardsticks as to normal and abnormal. L. G. Cole's The Pathological Yardstick, S. A. Portis' Gastroenterological Aspects of Psychosomatic Medicine, and the book edited by Sodeman, Pathological Physiology, are thought-provoking from this aspect, and the matter should be considered seriously by all doctors, but particularly by radiologists. How many of us remember all the ptotic stomachs that were tacked up as late as the twenties because the anatomists told us the stomach belonged in a certain position? It was radiology that corrected this error. Radiology can also be of great help in clarifying the subject of gastritis. History An historical review of the subject of gastritis divides itself into three periods, the high lights of which may be listed as follows: A. Period of Ascendancy, 1728–1838: 1728. G. E. Stahl is generally credited as being the first to mention gastritis as an entity. 1761. Morgagni went further and described signs of gastritis or inflammation of the stomach. 1808. Broussais gave the main impetus to the study and diagnosis of gastritis. He thought that gastritis was the cause of ascites and such diseases as typhoid fever and meningitis.