Impact of Helicobacter pylori infection on histological changes in non-erosive reflux disease

来源 :World Journal of Gastroenterology | 被引量 : 0次 | 上传用户:lin2009888
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AIM:The evidence for an association between Helicobacterpylori (H pylori) and gastroesophageal reflux disease,eitherin non-erosive (NERD) or erosive esophagitis (ERD) remainsuncertain.The available data on the histological changes inNERD and the effect on Hpyloriinfection on them are elusive.The aim of this study therefore was to prospectively evaluatethe histological findings and the impact of Hpyloriinfectionon a group of symptomatic patients with NERD.METHODS:Fifty consecutive patients were prospectivelyevaluated for symptoms compatible with GORD.In all cases,routine endoscopy and lugol directed biopsies were performedand assessed histologically in a blinded manner.RESULTS:The overall prevalence of Hpyloriinfection was70%.Twenty-nine patients out of 50 (58%) were NERDpatients.No statistical significance was observed betweenthe H pyloristatus and NERD.The remaining 21 (42%)were diagnosed as follows:13 (26%),6 (12%),2(4%) withesophagitis grade A,B and C respectively.A statisticallysignificant correlation was observed between the Hpylori+and esophagitis grade A,as well as between Hpylori-andgrade B.Biopsies from 2 patients were not included becauseof insufficient materials.Histologically,a basal zone hyperplasiawas found in 47 (97.91%) patients,alterations of glycogencontent in 47 (97.91%),papillae elongation in 33 (68.75%),blood vessels dilatation in 35(72.91%),chronic inflammationin 21 (43.75%),infiltration with eosinophils,neutophils andT-lymphocytes in 4 (8.33%),6 (12.5%) and 39 (81.25%)respectively.No correlation was observed between theHpyloristatus and the histological parameters studied eitherin NERD or GERD.CONCLUSION:Histological assessment can not differentiatesymptomatic patients with erosive versus non-erosive refluxdisease.Moreover,Hpyloriinfection may not act as animportant factor in patients with NERD. AIM: The evidence for an association between Helicobacter pylori (H pylori) and gastroesophageal reflux disease, eitherin non-erosive (NERD) or erosive esophagitis (ERD) remainsunrtain. The available data on the histological changes inNERD and the effect on Hpylori infection on them are elusive The aim of this study therefore was to prospectively evaluate the histological findings and the impact of Hpylori infection in 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 Twenty-nine patients out of 50 (58%) were NERDpatients. No statistical significance was observed betweent H pyloristatus and NERD. remaining 21 (42%) were diagnosed as follows: 13 (26%), 6 (12%), 2 (4%) withesophagitis grade A, B and C respectively. A statisticallysig nificant correlation was observed between the Hpylori + and esophagitis grade A, as well as between Hpylori-andgrade 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 infiltration with eosinophils, neutophils and T-lymphocytes in 4 (8.33%), glycopenecontent in 47 (97.91%), papillae elongation in 33 (68.75%), blood vessels dilatation in 35 (72.91%), chronic inflammationin 21 6 (12.5%) and 39 (81.25%) respectively. Correlation was observed between the Hpyloristatus and the histological parameters studied either in NERD or GERD. CONCLUSION: Histological assessment can not differentiatesymptomatic patients with erosive versus non-erosive reflux disease. Moreover, Hpylori infection may not act as animportant factor in patients with NERD.
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