Gastric Biopsy—A Critical Evaluation

MacDonald, Walter C.; Rubin, Cyrus E.

doi:10.1016/s0016-5085(19)34275-1

Cited by 36 publications

(7 citation statements)

References 145 publications

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“…In biopsy studies of normal people, few or no neutrophils are usually seen by subjective means. 24,25 Some authors see the presence of increased neutrophil infi ltration as implying that the infl ammatory process is active, particularly if seen in the epithelial cell layer. 26 This mucosal infl ammation may account for the symptoms in patients with non ulcer dyspepsia.…”

Section: Discussionmentioning

confidence: 99%

Gastric mucosal biopsies in non ulcer dyspepsia: A histopathologic study

2015

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Background: Non-ulcer dyspepsia (NUD) is a major health problem and one of the most common causes of morbidity and economic loss. The aim of the study was to determine the pattern of gastric mucosal histopathologic alterations and frequency of Helicobacter pylori in patients with NUD.Materials and Methods: Patients presenting to Gastroenterology Out Patient Department over a period of one year with symptoms of dyspepsia but without any endoscopic lesion were taken up for the study and evaluated by obtaining two gastric mucosal biopsy specimens each from antrum and body mucosa. The specimens were processed and examined histologically using the updated Sydney system.Results: Gastric biopsies from 102 patients (63 females and 39 males) with NUD were studied. Histological examination of gastric mucosal biopsies showed that 82.3% of NUD patients had histopathological features of gastritis. Chronic infl ammation was present in 84 (82.3%), activity was seen in 63 (61.7%), glandular atrophy was seen in 10 (9.8%) and intestinal metaplasia was seen in 4 (3.9%) patients with NUD on gastric biopsy. Maximum number of patients with NUD had Sydney score of less than 5 (68.6%).H pylori were identifi ed on gastric mucosal biopsies in 49 (48.0%) patients with NUD based on H & E and Geimsa stained sections.Conclusion: NUD is a clinical problem which occurs in both sexes in all age groups; prevalence being low below 20 years of age. Patients with this condition have a high frequency of gastric mucosal inflammation and H pylori infection.Asian Journal of Medical Sciences Vol.7(2) 2015 80-84

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Section: Discussionmentioning

confidence: 99%

Gastric mucosal biopsies in non ulcer dyspepsia: A histopathologic study

2015

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“…Because the oxyntic glands remain intact, and because there is no deterioration of these glands with time, acid secretion can remain normal in these patients throughout the ageing process 61 , . 63 , 70 , 71 …”

Section: Atrophic Gastritis and Intestinal Metaplasiamentioning

confidence: 99%

Review article: potential gastrointestinal effects of long‐term acid suppression with proton pump inhibitors

Laine

Ahnen

McClain

et al. 2000

Aliment Pharmacol Ther

229

151

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This review examines the evidence for the development of adverse effects due to prolonged gastric acid suppression with proton pump inhibitors. Potential areas of concern regarding long‐term proton pump inhibitor use have included: carcinoid formation; development of gastric adenocarcinoma (especially in patients with Helicobacter pylori infection); bacterial overgrowth; enteric infections; and malabsorption of fat, minerals, and vitamins. Prolonged proton pump inhibitor use may lead to enterochromaffin‐like cell hyperplasia, but has not been demonstrated to increase the risk of carcinoid formation. Long‐term proton pump inhibitor treatment has not been documented to hasten the development or the progression of atrophic gastritis to intestinal metaplasia and gastric cancer, although long‐term studies are required to allow definitive conclusions. At present, we do not recommend that patients be tested routinely for H. pylori infection when using proton pump inhibitors for prolonged periods. Gastric bacterial overgrowth does increase with acid suppression, but important clinical sequelae, such a higher rate of gastric adenocarcinoma, have not been seen. The risk of enteric infection may increase with acid suppression, although this does not seem to be a common clinical problem with prolonged proton pump inhibitor use. The absorption of fats and minerals does not appear to be significantly impaired with chronic acid suppression. However, vitamin B12 concentration may be decreased when gastric acid is markedly suppressed for prolonged periods (e.g. Zolllinger–Ellison syndrome), and vitamin B12 levels should probably be assessed in patients taking high‐dose proton pump inhibitors for many years. Thus, current evidence suggests that prolonged gastric acid suppression with proton pump inhibitors rarely, if ever, produces adverse events. Nevertheless, continued follow‐up of patients taking proton pump inhibitors for extended periods will provide greater experience regarding the potential gastrointestinal adverse effects of long‐term acid suppression.

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“…Radiological examination has shown that the biopsy tube usually runs from the oesophagus to the greater curve of the stomach, so that the biopsy specimen comes from the greater curve or close to it. Pyloric mucosa is seldom obtained (Macdonald and Rubin, 1967).…”

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confidence: 99%