Alkaline Reflux Gastritis

Burden, William R.; Hodges, Richard P.; Hsu, Michael; O’Leary, J. Patrick

doi:10.1016/s0039-6109(16)45331-4

Cited by 31 publications

(13 citation statements)

References 18 publications

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“…It has also been referred to as reflux gastritis, chemical gastritis, and Type C gastritis. The condition was originally described in the stomachs of patients who had undergone gastric surgery (62)(63)(64). It was found to be most common after Billroth II gastrectomy but was also encountered after vagotomy and pyloroplasty (64).…”

Section: Reactive Gastropathymentioning

confidence: 99%

“…The condition was originally described in the stomachs of patients who had undergone gastric surgery (62)(63)(64). It was found to be most common after Billroth II gastrectomy but was also encountered after vagotomy and pyloroplasty (64). More recently, it has become recognized that reactive gastropathy may be seen in the intact stomach (65).…”

Section: Reactive Gastropathymentioning

confidence: 99%

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Gastritis and Carditis

Owen

2003

Modern Pathology

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Dyspepsia is a common clinical problem. Its causes include peptic ulcer disease, gastroesophageal reflux, and functional (nonulcer) dyspepsia. A detailed clinical description of pain does not reliably differentiate the cause. Approximately 80% of gastroscopies are performed for the investigation of dyspepsia. "Gastritis" is diagnosed endoscopically in 59% of all stomachs, although in only 3% are the changes severe. Pathologic examination of unselected gastric biopsy specimens reveals that abnormalities are present in 62-73%, but there is only a weak correlation between endoscopic and histologic findings. For these reasons, it is recommended that endoscopic examination should always be accompanied by biopsy. Ideally, biopsies should be taken in a systematic fashion to include sampling of antrum and corpus. Recent evidence suggests that gastric infection by Helicobacter pylori initially presents as a superficial gastritis. Later it may become atrophic with development of intestinal metaplasia. The onset of atrophic changes may be related to the duration of infection, the strain of the infecting organism, associated dietary factors, or as-yet undefined host factors related to immunity. Persistent superficial gastritis predisposes to duodenal ulcer and gastric mucosa-associated lymphoid tissue lymphoma. Atrophic gastritis predisposes to gastric ulcer and adenocarcinoma. Evidence is accumulating that in some patients, pernicious anemia may be an end result of H. pylori-induced atrophic gastritis. Reactive gastropathy is a relatively common finding in gastric biopsies; in most instances it is associated with either reflux of duodenal contents or therapy with nonsteroidal anti-inflammatory drugs. Lymphocytic gastritis, eosinophilic gastritis, and the gastritis associated with Crohn's disease are distinct morphologic entities. Most gastroscopies are performed for the investigation of dyspepsia (1-7). This is a common clinical problem but is rarely life-threatening. The causes of dyspepsia include peptic ulcer disease (30%), gastroesophageal reflux (29%), and nonulcer (functional) dyspepsia (40%). The cause of functional dyspepsia is unclear at the present time, although in many instances it may be related to abnormalities of gut motility. In Ͻ1% of cases is gastric cancer a cause of dyspepsia. A detailed description of the symptoms of dyspepsia does not reliably differentiate the cause, although the presence of heartburn strongly suggests a component of gastroesophageal reflux. Correlations among patient symptoms, endoscopic appearances, and biopsy findings of gastritis are imperfect (4 -6). Agreement is best in cases where peptic ulcer or another focal lesion is identified. A study by Khakoo et al. (7) from the United Kingdom illustrates the problems encountered. Endoscopic and histologic findings were reviewed in 167 patients who underwent gastroscopy for dyspeptic symptoms. Of these, 98 patients (57%) had endoscopic evidence of gastritis. In 42% of patients, gastritis involved the antrum alone, in 7% it involved the...

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Section: Reactive Gastropathymentioning

confidence: 99%

Section: Reactive Gastropathymentioning

confidence: 99%

Gastritis and Carditis

Owen

2003

Modern Pathology

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“…DGR also occurs in 30% to 40% of adult patients presenting acid reflux oesophagitis with brachy-oesophagus [1,19]. Its importance is related to the chronic injurious effects of bile acids and duodenal contents on the mucosa of the stomach and oesophagus that could predispose to gastric ulcers [5] and malignant transformation [9]. Reflux of duodenal contents into the stomach and subsequently into the oesophagus is a physiological event of short duration that rarely causes symptoms [9,17,29].…”

Section: Introductionmentioning

confidence: 99%

Primary duodenogastric reflux in children and adolescents

Hermans

Sokal

Collard

et al. 2003

European Journal of Pediatrics

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“…Therefore, while conventional radiography using contrast plays a marginal role [1, 2, 3] – we have never been able to document reflux by this means –, instrumental diagnosis using various procedures (EGDS, gastric pH-metry, HIDA radionuclide scanning) permits an accurate diagnosis to be made in an increasing number of cases, if utilized appropriately [1, 2, 3, 4, 5]. In fact, while endoscopy associated with biopsy permits a direct documentation of reflux effects, lengthened or established time analysis allows the quantitative examination of reflux and, most importantly, a more accurate correlation between the presence of reflux and the onset of symptoms.…”

Section: Discussionmentioning

confidence: 99%

“…Alkaline gastritis due to pathologic duodenogastric reflux (DGR) has been mainly described following gastric surgery or other procedures that can alter gastropyloric function [1, 2, 3]. Several reports describe typical symptoms (epigastric pain unrelieved by antacids or foods, bile vomiting and weight loss), endoscopic findings and histologic features in patients with intact stomach [3, 4, 5], although the pathogenetic mechanisms involved in primary DGR remain difficult to understand.…”

Section: Introductionmentioning

confidence: 99%

Truncal Vagotomy, Antrectomy and Roux-en-Y Gastrojejunostomy in the Treatment of Duodenogastric Reflux Disease

Im¹,

Brisinda²,

Palermo³

et al. 1998

Dig Surg

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Background/Aims: The surgical treatment of duodenogastric reflux (DGR), resistant to medical therapy, in patients with intact stomach is difficult to standardize. The aim of this study is to present our experience on 5 patients, all cholecystectomized, with severe DGR disease treated surgically. Methods: Out of a group of 223 patients suffering from nonulcerous dispeptic pathology presenting to our department, we selected 5 patients suffering from alkaline reflux gastritis in intact stomach. The diagnosis of primary DGR was made using Wilson’s criteria. The surgical procedure adopted consisted of a truncal vagotomy, antrectomy, and a Roux-en-Y gastrojejunostomy. Results: No perioperative mortality was observed. Twelve months after surgery all patients expressed satisfaction with the result of the operation and complained of no severe disturbances. A sense of postprandial fullness with a sense of pain in the left shoulder persisted in one case only, requiring the consumption of small and frequent meals. Radiological examination of the upper gastrointestinal tract of these patients showed notably delayed emptying of the gastric stump, while the endoscopic picture was completely normal. Conclusion: The antrectomy and Roux-en-Y gastrojejunostomy is a better known operation, easily executed, and has the advantage that it can be performed on patients previously operated on for gastric resection and therefore suffering from secondary reflux. It also has the advantage of removing the gastric antrum where mucous atrophy is more frequent and is susceptible to neoplastic degeneration. However, at the present time the choice between different types of operation depends exclusively on the personal conviction and experience of the surgeon.

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Alkaline Reflux Gastritis

Cited by 31 publications

References 18 publications

Gastritis and Carditis

Gastritis and Carditis

Primary duodenogastric reflux in children and adolescents

Truncal Vagotomy, Antrectomy and Roux-en-Y Gastrojejunostomy in the Treatment of Duodenogastric Reflux Disease

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