Etiological involvement of Helicobacter pylori in "reflux" gastritis after gastrectomy.
OBJECTIVE
"Reflux" gastritis after gastrectomy is associated with various symptoms that are often detrimental to the patients' quality of life. However, prevention of the reflux does not always bring relief from the symptoms of gastritis. Helicobacter pylori (H. pylori) is now considered one of the most important pathogenetic factors in gastritis. The association between H. pylori infection and reflux gastritis after gastrectomy was investigated in the present study.


METHODS
In total, 115 patients who had undergone gastrectomy were entered in this study. Five biopsy specimens from the gastric remnant were taken during upper GI endoscopy. One specimen was examined pathohistologically, and the remaining four were examined for H. pylori infection. The histological degree of gastritis was determined according to the score system of Rauws et al.


RESULTS
Forty-six patients (40%) demonstrated H. pylori infection in their stomachs. The prevalence of the infection was significantly higher in patients with conventional gastrectomy than in those with subtotal gastrectomy. The prevalence of H. pylori infection was significantly lower in patients who had undergone gastrectomy more than 4 yr ago. The histological gastritis score in patients with H. pylori infection was significantly higher than in those without H. pylori infection. Furthermore, the eradication of H. pylori in patients with both serious gastritis symptoms and no bile reflux improved the symptoms and significantly decreased the histological gastritis score.


CONCLUSIONS
The results suggest that H. pylori is a factor in the pathogenesis of reflux gastritis after gastrectomy.
Nagahata
Y
Y
First Department of Surgery, Kobe University School of Medicine, Japan.
Kawakita
N
N
Azumi
Y
Y
Numata
N
N
Yano
M
M
Saitoh
Y
Y
D000658:Amoxicillin / Q000627:therapeutic use; D000897:Anti-Ulcer Agents / Q000627:therapeutic use; D002599:Chalcone / Q000031:analogs & derivatives / Q000627:therapeutic use; D047188:Chalcones; D004359:Drug Therapy, Combination; D005260:Female; D005753:Gastric Mucosa / Q000382:microbiology / Q000473:pathology; D018530:Gastric Stump; D005756:Gastritis / Q000382:microbiology*; D016481:Helicobacter Infections / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008875:Middle Aged; D009853:Omeprazole / Q000627:therapeutic use; D010406:Penicillins / Q000627:therapeutic use; D011178:Postgastrectomy Syndromes / Q000382:microbiology*; D015995:Prevalence; D012307:Risk Factors
D000897:Anti-Ulcer Agents; D047188:Chalcones; D010406:Penicillins; C035032:sofalcone; D002599:Chalcone; D000658:Amoxicillin; D009853:Omeprazole