Intragastric bile acids and histological changes in gastric mucosa

Houghton, P. W.; Mortensen, N. J. McC.; Thomas, W. E. G.; Cooper, M. J.; Morgan, Anthony; Burton, P.

doi:10.1002/bjs.1800730509

Cited by 33 publications

(12 citation statements)

References 18 publications

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“…Houghton et al [29] found a good correlation between TBA concentration and atrophic gastritis, intestinal metaplasia and dysplasia but the majority of their patients were postoperative. In our series of intact stomachs, there were no significant correla tions between bile reflux and the presence of atrophic gastritis or intestinal metaplasia in H. pylori -ve elderly patients.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous Bile Reflux in the Elderly

Safe¹,

Nwose²,

Sheehan

et al. 1993

Gerontology

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Duodenogastric bile reflux is common in postoperative stomach but has been reported in intact stomachs. Spontaneous bile reflux in the elderly has not been studied before. This has been assessed in dyspeptic elderly and young patients. Total bile acid (TBA) levels and pH were measured in the samples of fasting gastric juice. Antral biopsies were taken for histological examination including Helicobacter pylori identification. TBA levels were significantly higher in elderly patients with gastritis in comparison to elderly and young normal groups. Only 10% of elderly patients with gastritis and 7% with gastric ulcer has abnormal TBA ( > 1 mmol/l). There was some correlation between the pH and TBA but a significant proportion of elderly patients has pH > 4 with a normal TBA. TBA levels were not significantly different in H. pylori +ve and H. pylori -ve patients. Nineteen elderly patients had evidence of reactive gastritis. Five of these patients had raised TBA levels with severe H. pylori infection. The remaining 15 patients had normal TBA. These patients were on NSAIDs and 4 of them had H. pylori infection. We conclude that spontaneous bile reflux in the elderly is uncommon. Hypochlorhydria which is observed in the elderly is not caused by alkaline bile reflux. The main cause of reactive gastritis in the elderly is NSAIDs ingestion.

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Section: Discussionmentioning

confidence: 99%

Spontaneous Bile Reflux in the Elderly

Safe¹,

Nwose²,

Sheehan

et al. 1993

Gerontology

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“…Intragastric mutagens also may be synthetized in the non-atrophic, acidic stomach from primary amines, phenolic or other aromatic compounds. [67][68][69] Reflux of bile into the stomach is another potential inducer of intestinal metaplasia 70 but, for this action, the synergistic influence of the underlying gastritis may also be necessary. In subjects not carrying H. pylori, intragastric bile is not capable of inducing intestinal metaplasia 71,72 even though there is evidence that bile can induce cancers in animals without other contributing factors.…”

mentioning

confidence: 99%

Pathogenesis of the transformation from gastritis to malignancy

Sipponen¹,

Hyvärinen

Seppälä

et al. 1998

Aliment Pharmacol Ther

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cause of chronic gastritis, and on the knowledge of the natural course of chronic gastritis from non-atrophic gastritis to atrophic gastritis and intestinal metaplasia, and to precancerous lesions ( Figure 1). Prospective cohort studies are also considered to indicate strongly an association of H. pylori infection with gastric cancer. 1Our knowledge of the global epidemiology and time trends of gastric cancer indicates the importance of environmental factors in cancer pathogenesis. The timerelated changes in gastric cancer incidence have been substantial over the years but these changes are surprisingly similar worldwide, suggesting that one or some environmental agents play a critical role globally in gastric carcinogenesis.

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“…Mosimann et al 11 found a significant association between a gastric pH greater than 4, positive duodenagastric reflux as ascertained by the scintigraphic technique, and the presence of gastric dysplasia in 36 asymptomatic patients who had undergone duodenal ulcer surgery 7 or more years earlier. Finally, Houghton et al 3 conducted an endoscopic biopsy and gastric aspirate study in 108 patients and found that the total bile acid concentration was significantly higher in the 70 patients with gastric dysplasia than in the other 38 patients (P=O.OI, Mann-Whitney U test).…”

Section: Discussionmentioning

confidence: 99%

Duodeno-gastric Reflux and Gastric Adenomas: A Scintigraphic Study in Patients with Familial Adenomatous Polyposis

1991

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SummaryTo test whether the presence of gastric adenomas (dysplasia) was associated with gastric reflux of duodenal contents, six patients with familial adenomatous polyposis (FAP) who had gastric adenomas and nine matched FAP patients without gastric adenomas underwent scintigraphic duodeno-gastric reflux scanning. Reflux was graded 0-6, where O=no reflux, l=intermittent reflux into antrum only, 2=prolonged reflux into antrum only, 3=intermittent reflux into body, 4=prolonged reflux into body, 5=intermittent reflux into body and fundus, and 6=prolonged reflux into body and fundus. FAP patients with gastric adenomas had more severe reflux (median 6, range 4-6) than did controls (median 3, range 0-6; P=0.009, Mann-Whitney U test). These results are consistent with a role for bile in the development of gastric adenomatous polyps and suggest that bile is involved in the dysplasiacarcinoma sequence.

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Intragastric bile acids and histological changes in gastric mucosa

Cited by 33 publications

References 18 publications

Spontaneous Bile Reflux in the Elderly

Spontaneous Bile Reflux in the Elderly

Pathogenesis of the transformation from gastritis to malignancy

Duodeno-gastric Reflux and Gastric Adenomas: A Scintigraphic Study in Patients with Familial Adenomatous Polyposis

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