Effect of Duodenal Ulcer Surgery and Enterogastric Reflux on Gampylobacter Pyloridis

O'Connor, H.J.; Wyatt, J I; Ward, Daniel; Dixon, M. F.; Axon, Anthony; Dewar, E. P.; Johnston, D.

doi:10.1016/s0140-6736(86)92193-8

Cited by 124 publications

(44 citation statements)

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“…We observed that the prevalence decreased with time after surgery, although there was no intentional eradication. Inhibition of H. pylori colonization by bile reflux has been observed [16], and a transition from H. pyloriassociated gastritis to reflux gastritis in the GR after peptic ulcer surgery was suggested [25]. Similar findings were demonstrated in the present study.…”

Section: Discussionsupporting

confidence: 91%

“…Eradication of H. pylori in the post-operative GR after gastrectomy for early-stage primary gastric carcinoma has been recommended [15]. Several studies have investigated the effect of partial gastrectomy on H. pylori infection [16][17][18]. Most of these were, however, studies of peptic ulcer patients, and to date there have been only a few small studies of H. pylori involvement after gastric cancer operation [19,20].…”

Section: Introductionmentioning

confidence: 99%

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Prevalence of Helicobacter pylori infection in gastric remnant after distal gastrectomy for primary gastric cancer

et al. 2001

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therapy has improved, and a long postoperative life is usual in a majority of these patients with early-stage gastric carcinoma [1]. However, in these patients, the gastric remnant (GR) retains the mucosa that had been the background of the initial cancer, and the mucosa exists in nonphysiological circumstances. Thus, the possible development of a second primary cancer in the GR has been a problem. In practice, the incidence of a second primary cancer in the GR is considerably high. At our institute, second primary cancer in the GR was found in approximately 2% of the patients after curative resection of primary gastric carcinoma [2]. Thus, post-operative endoscopic surveillance has been emphasized to detect curable early-stage cancer in the GR [3].Our previous study demonstrated that the features of early-stage second primary cancer in the GR were somewhat different from those of ordinary primary gastric carcinoma; protruding lesions and intestinal type cancer were dominant, and the background mucosa of these lesions was often associated with atrophic gastritis or intestinal metaplasia [2,4]. Although the real cause of gastric carcinogenesis is not fully understood, several environmental factors, including infection with Helicobacter pylori, have been shown to be linked with gastric carcinogenesis [5]. Since Warren and Marshall [6] first isolated H. pylori from the stomachs of patients with gastritis, numerous studies have demonstrated the relationship between H. pylori infection and the development of gastric cancer [7][8][9][10]. Now, H. pylori is regarded as a definite carcinogen [11] and as a trigger for the sequence of carcinogenesis, because there is strong evidence for H. pylori infection as a cause of chronic atrophic gastritis and intestinal metaplasia, two possible precancerous lesions [9,10,[12][13][14]. Our previous observations on the background mucosa of early-stage carcinoma of the GR also indicated an intimate association between atrophic gastritis and intestinal-type gastric carcinoma [2]. Thus, involvement of H. pylori in carAbstract Background. The development of a second primary cancer in the gastric remnant after gastrectomy for early gastric carcinoma is a problem, and eradication of Helicobacter pylori after the operation has been recommended. However, to date, practical indications for H. pylori eradication after gastric cancer surgery have not yet been reported. Methods. We examined H. pylori infection in the gastric remnant after distal gastrectomy for primary gastric cancer. One hundred and nine patients who had had a gastrectomy were studied. Endoscopic findings and results from the urease test, bacteriologic assessment, serological test, and histopathological examination were analyzed. Results. Seventy-one patients (65.1%) were judged to be positive for H. pylori infection. The prevalence of H. pylori infection was found to be significantly decreased in older patients, patients in whom the operation had been performed a long time before examination, patients with symptoms, and pati...

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Prevalence of Helicobacter pylori infection in gastric remnant after distal gastrectomy for primary gastric cancer

et al. 2001

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“…A possible explanation was proposed by O'Connor and colleagues (95,96). They found that C. pylori seemed to be absent in patients with high duodenogastric reflux and suggested that reflux gastritis represents a distinct entity.…”

Section: Nudmentioning

confidence: 97%

Campylobacter pylori and gastroduodenal disease

Buck

1990

Clin Microbiol Rev

138

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Campylobacter pylori is a newly described, spiral-shaped, gram-negative bacillus that is oxidase positive, catalase positive, and urease positive and grows slowly in culture. Although observed in human tissue at the beginning of the century, it was not cultured until 1982. Because there are significant morphological and genetic differences between this organism and other species of Campylobacter, it will probably be reclassified in a new genus. Current information indicates that the organism primarily resides in the stomach tissue of humans and nonhuman primates and may occasionally spread to the esophagus or other parts of the alimentary tract under appropriate conditions. Significant evidence has accumulated in the last several years to show that it causes gastritis, and there is mounting evidence that it may participate in the development of duodenal ulcers. It may also be associated with gastric ulcers and nonulcer dyspepsia. It can be detected in patients by culture of biopsy specimens or histological staining of biopsy tissue. Indirect evidence for the presence of the organism can be obtained by detection of urease in a tissue biopsy specimen, by urea breath tests, or by detection of specific antibody. It may not be necessary to implement these procedures for routine use, however, until the role of the organism can be defined better. Ultimately, the discovery of this organism may lead to radical changes in the diagnosis and treatment of gastric disease.

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“…Ultrastructual studies have demon strated a close relationship between the bac teria and epithelial cell damage [32], C. py lori are rarely found in patients with histo logically normal antral mucosa [28,33,34] and are not present in areas of intestinal metaplasia [35], The organisms do not col onize patients with chronic specific gastritis, such as gastric Crohn's disease or eosino philic gastritis in children [36]. C. pylori tend to be seen uncommonly in patients with type A gastritis [37] and in postgastrectomy patients with duodenogastric-reflux associ ated gastritis [38], The data suggest that the organisms are specifically associated with id iopathic type B gastritis. Moreover, in two separate experiments a healthy volunteer has ingested C. pylori [39,40]; both volunteers developed acute gastritis, and in one case active chronic gastritis has persisted [40].…”

Section: Infection and Chronic Gastritis Campylobacter Pylorimentioning

confidence: 99%

“…In these patients duodenogastric re flux may play an important role [38,55]. Indeed, duodenogastric reflux has been asso ciated with antral but not fundal gastritis in the intact stomach [56], This may not be a cause-and-effect relationship, however, other studies have been unable to correlate duodenogastric reflux with gastritis [57,58], and improvement in histology following bile diversion operations are not well docu mented [55,59], Alternatively, trophic gas trointestinal hormones such as gastrin may be interfered with by antrectomy, and possi bly vagotomy, predisposing to gastritis [60].…”

Section: Duodenogastric Reflux and Postgastrectomy Gastritismentioning

confidence: 99%

Chronic (Nonerosive) Gastritis: Pathogenesis and Management

Talley

1989

Dig Dis

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Effect of Duodenal Ulcer Surgery and Enterogastric Reflux on Gampylobacter Pyloridis

Cited by 124 publications

References 20 publications

Prevalence of Helicobacter pylori infection in gastric remnant after distal gastrectomy for primary gastric cancer

Prevalence of Helicobacter pylori infection in gastric remnant after distal gastrectomy for primary gastric cancer

Campylobacter pylori and gastroduodenal disease

Chronic (Nonerosive) Gastritis: Pathogenesis and Management

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