title: Histological features of the gastric mucosa in children with primary bile reflux gastritis.
abstract: BACKGROUND
  Bile reflux is one of the primary factors involved in the pathogenesis of gastric mucosal lesions in patients with chronic gastritis; however, little is known about the exact histological features of bile reflux and its contributions to gastric mucosal lesions in this disease, especially in children with primary bile reflux gastritis (BRG). The aim of this study was to investigate the classic histological changes of the gastric mucosa in children with primary BRG.
  
  
  METHODS
  The Bilitec 2000 was used for 24 h monitoring of gastric bile in 59 children with upper gastrointestinal symptoms. The histological characteristics of the gastric mucosa were examined and scored.
  
  
  RESULTS
  Thirteen of the 59 patients had a helicobacter pylori infection and were excluded; therefore, 46 cases were included in this study. The positive rate of pathological duodenogastric reflux was significantly higher in patients with foveolar hyperplasia than those without foveolar hyperplasia; however, the rate was significantly lower in patients with vascular congestion than those without vascular congestion. The longest reflux time and the total percentage time of bile reflux were significantly lower in patients with vascular congestion than those without vascular congestion. A total of 9 types of histological changes were analyzed using a binary logistic regression. Foveolar hyperplasia and vascular congestion in the superficial layer became significant variables in the last step of the stepwise regression.
  
  
  CONCLUSIONS
  Foveolar hyperplasia was associated with the severity of bile reflux, suggesting that it is a histological feature of primary BRG in children, while vascular congestion may be a protective factor.
authors.affiliation: Department of Gastroenterology, Children's Hospital, Zhejiang University School of Medicine, Key Laboratory of Reproductive Genetics (Zhejiang University), Ministry of Education, Hangzhou 310003, P.R. China.
authors.forename: Yanyi
authors.initials: Y
authors.lastname: Zhang
authors.forename: Xi
authors.initials: X
authors.lastname: Yang
authors.forename: Weizhong
authors.initials: W
authors.lastname: Gu
authors.forename: Xiaoli
authors.initials: X
authors.lastname: Shu
authors.forename: Ting
authors.initials: T
authors.lastname: Zhang
authors.forename: Mizu
authors.initials: M
authors.lastname: Jiang
mesh_terms: D000293:Adolescent; D001655:Bile Reflux / Q000150:complications* / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D005753:Gastric Mucosa / Q000473:pathology*; D005756:Gastritis / Q000209:etiology* / Q000473:pathology*; D005764:Gastroesophageal Reflux / Q000150:complications* / Q000473:pathology; D016481:Helicobacter Infections / Q000150:complications / Q000473:pathology; D016480:Helicobacter pylori / Q000472:pathogenicity; D006801:Humans; D006965:Hyperplasia / Q000150:complications* / Q000473:pathology; D008297:Male; D011379:Prognosis