H Pylori
Copyright ©The Author(s) 2004. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Apr 15, 2004; 10(8): 1180-1182
Published online Apr 15, 2004. doi: 10.3748/wjg.v10.i8.1180
Impact of Helicobacter pylori infection on histological changes in non-erosive reflux disease
Anthie Gatopoulou, Konstantinos Mimidis, Alexandra Giatromanolaki, Alexandros Polichronidis, Nikolaos Lirantzopoulos, Efthimios Sivridis, George Minopoulos
Anthie Gatopoulou, Konstantinos Mimidis, George Minopoulos, Endoscopy Unit, Democritus University of Thrace, Alexandroupolis, Greece
Konstantinos Mimidis, First Department of Internal Medicine, Democritus University of Thrace, Alexandroupolis, Greece
Efthimios Sivridis, Alexandra Giatromanolaki, Department of Pathology, Democritus University of Thrace, Alexandroupolis, Greece
Alexandros Polichronidis, Second Department of Surgery, Democritus University of Thrace, Alexandroupolis, Greece
Nikolaos Lirantzopoulos, George Minopoulos, First Department of Surgery, Democritus University of Thrace, Alexandroupolis, Greece
Author contributions: All authors contributed equally to the work.
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Received: September 15, 2003
Revised: October 23, 2003
Accepted: November 15, 2003
Published online: April 15, 2004
Abstract

AIM: The evidence for an association between Helicobacter pylori (H pylori) and gastroesophageal reflux disease, either in non- erosive (NERD) or erosive esophagitis (ERD) remains uncertain. The available data on the histological changes in NERD and the effect on H pylori infection on them are elusive. The aim of this study therefore was to prospectively evaluate the histological findings and the impact of H pylori infection on a group of symptomatic patients with NERD.

METHODS: Fifty consecutive patients were prospectively evaluated for symptoms compatible with GORD. In all cases, routine endoscopy and lugol directed biopsies were performed and assessed histologically in a blinded manner.

RESULTS: The overall prevalence of H pylori infection was 70%. Twenty-nine patients out of 50 (58%) were NERD patients. No statistical significance was observed between the H pylori status and NERD. The remaining 21 (42%) were diagnosed as follows: 13 (26%), 6 (12%), 2(4%) with esophagitis grade A, B and C respectively. A statistically significant correlation was observed between the H pylori+ and esophagitis grade A, as well as between H pylori- and grade B. Biopsies from 2 patients were not included because of insufficient materials. Histologically, a basal zone hyperplasia was found in 47 (97.91%) patients, alterations of glycogen content in 47 (97.91%), papillae elongation in 33 (68.75%), blood vessels dilatation in 35(72.91%), chronic inflammation in 21 (43.75%), infiltration with eosinophils, neutophils and T-lymphocytes in 4 (8.33%), 6 (12.5%) and 39 (81.25%) respectively. No correlation was observed between the H pylori status and the histological parameters studied either in NERD or GERD.

CONCLUSION: Histological assessment can not differentiate symptomatic patients with erosive versus non-erosive reflux disease. Moreover, H pylori infection may not act as an important factor in patients with NERD.

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