Assessment of Gastric Acidity by Conventional Endoscopy With Serological Gastric Markers

Abstract

BackgroundGastric acidity could determine Helicobacter pylori (H. pylori)-associated gastritis patterns. In reverse, H. pylori infection could lead disturbance in gastric acid secretion. We attempted to elucidate gastric acid status by conventional endoscopy with pepsinogen test.MethodsA total of 196 subjects who visited our health promotion center were consecutively enrolled and evaluated by conventional endoscopy, and blood examinations with pepsinogen I, II, and fasting serum gastrin were conducted. As a Japanese study suggested that in H. pylori-positive subjects the cutoff value was PG I/II ratio ≤ 2.7 for hypochlorhydia, PG I/II ratio ≥ 3.3 for hyperchlorhydria. Based on these serological data, we compared conventional endoscopic images with each acid level.ResultsIt showed that for hypoacidity, older age, and most of the H. pylori-associated endoscopic appearances featuring mucosal inflammation and more atrophy of corpus or antrum were in favor of hypoacidity in closed type. Mucosal appearances showing severe corpus atrophy and remnant gastritis with advanced background atrophy determine hypoacidity in open type. For hyperacidity, mucosal appearances featuring intact mucosa and less severe atrophy were associated with hyperacid status. Male gender, antrum camouflage were also involved in hyperacidity.ConclusionsConventional endoscopy with pepsinogen test could be useful in gastric acid assessment.

In situ Diagnosis of Helicobacter pylori Infection Using the Endoscopic Kyoto Scoring System

“…pressed erosion known to have positive correlations with H. pylori infection, whereas regular arrangement of collecting venules (RAC), fundic gland polyp, red streaks, raised erosion, hematin, patchy redness, and map-like redness are negatively correlated with H. pylori infection. [9][10][11][12] Several endoscopic features have low response rates for endoscopists. For example, fundic gland polyp and map like redness have low response rates due to their rarity, although these are closely related to H. pylori negative infection.…”

Endoscopic gastric mucosal atrophy as a predictor of colorectal polyps: a large scale case-control study

“…(11,21) The extent of GMA can be evaluated with the updated Sydney System using biopsy specimens, serum pepsinogen or gastrin levels, and the pH value of gastric juice. (27)(28)(29) However, these methods are not only invasive but also timeconsuming and expensive. Alternatively, GMA can be easily diagnosed by trained endoscopists.…”