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Morphological changes of the gastric mucosa in patients with duodenogasric reflux: relationship with acidity and helicobacter pylori

Abstract

Purpose: to reveal the peculiarities of the duodenogastric reflux (DGR) impact on acidity and morphological features of the gastric mucosa in patients with "primary" reflux gastritis, as well as in cases of reflux gastritis in combination with H. pylori. Methods: 66 patients with chronic reflux gastritis were examined, 15 people formed a control group. All patients had gastric endoscopy with determination of the gastric acidity and concentration of bile acids. Biopsy material for histological examination was obtained from 55 patients, in 12 cases of suspected intestinal metaplasia additional histochemical (PAS and alcian blue) and immunohistochemical (cytokeratin 20, Villin, carcinoembriogenic antigen, MUC2, CD45) assays were performed. Results: the level of acidity in patients with DGR was higher (pH = 3.55 ± 2.3) compared to the control group (pH = 6.85 ± 1.34). Cases of DGR differed from the control group regarding the mononuclear infiltration (p=0,001), foveolar hyperplasia (p=0,001) in both antral and fundic parts of the stomach, mucosal edema (p=0,022) and atrophy (p=0,02) at the level of the antrum, and intestinal metaplasia (p=0,022) at the level of the body. In the presence of H. pylori infection, in addition to the abovementioned signs, infiltration by cells of acute inflammation (p = 0.005) was detected, which indicates an increase in the damaging effect of H. pylori infection in DGR. Conclusion: DGR may lead to "oxidation" of gastric contents. The effect of DGR leads to intestinal metaplasia of the body and atrophy of the antral part of stomach, chronic inflammation and foveolar hyperplasia. The presence of H. pylori boosts the morphological changes in the gastric mucosa caused by DGR.

About the Authors

Sh. Z. Galiev
ФГБОУ ВО Казанский государственный медицинский университет Минздрава России; Республиканский клинический онкологический диспансер Министерства здравоохранения Республики Татарстан
Russian Federation


N. B. Amirov
ФГБОУ ВО Казанский государственный медицинский университет Минздрава России; Республиканский клинический онкологический диспансер Министерства здравоохранения Республики Татарстан
Russian Federation


T. R. Akhmetov
ФГБОУ ВО Казанский государственный медицинский университет Минздрава России; Республиканский клинический онкологический диспансер Министерства здравоохранения Республики Татарстан
Russian Federation


S. V. Petrov
ФГБОУ ВО Казанский государственный медицинский университет Минздрава России; Республиканский клинический онкологический диспансер Министерства здравоохранения Республики Татарстан
Russian Federation


A. G. Sabirov
ФГБОУ ВО Казанский государственный медицинский университет Минздрава России; Республиканский клинический онкологический диспансер Министерства здравоохранения Республики Татарстан
Russian Federation


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Review

For citations:


Galiev SZ, Amirov NB, Akhmetov TR, Petrov SV, Sabirov AG. Morphological changes of the gastric mucosa in patients with duodenogasric reflux: relationship with acidity and helicobacter pylori. Ural Medical Journal. 2018;(2):91-96. (In Russ.)

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ISSN 2071-5943 (Print)
ISSN 2949-4389 (Online)