Relation between bile acid reflux into the stomach and the risk of atrophic gastritis and intestinal metaplasia: a multicenter study of 2283 cases.
BACKGROUND
The relationship between bile acid reflux into the stomach and the risk of atrophic gastritis and intestinal metaplasia is still not well understood. Towards obtaining a better understanding, concentrations of bile acids were measured.


METHODS
This study was carried out with the participation of 14 facilities in Japan, and 2283 samples were collected. The subjects with bile acid concentrations equal to or higher than the limit of detection were divided into four groups of equal size (group A: 0-25%, group B: 26-50%, group C: 51-75%, and group D: 76-100%). Thus, including the control group, there were five groups in total. The odds that the control group would develop atrophic gastritis and intestinal metaplasia was set as 1,and the odds ratios (OR) in groups A, B, C and D were calculated based on the odds in the control group.


RESULTS
Regarding the development of atrophic gastritis, no increased risk was observed in either the Helicobacter pylori (H. pylori)-positive or -negative cases. The OR for the development of intestinal metaplasia were significantly higher, for both cases with and without H. pylori infection, in group D.


CONCLUSIONS
High concentrations of bile acid seem to be associated with an elevated risk of intestinal metaplasia.
Department of Gastroenterology, Tama-Nagayama University Hospital, Nippon Medical School, Tokyo, Japan. matuhisa@m8.dion.ne.jp
Takeshi
T
Matsuhisa
Tetsuo
T
Arakawa
Tetsuo
T
Watanabe
Tadashi
T
Tokutomi
Kouichi
K
Sakurai
Seisuke
S
Okamura
Shinji
S
Chono
Tomoari
T
Kamada
Atsushi
A
Sugiyama
Yoshinori
Y
Fujimura
Kenji
K
Matsuzawa
Masanori
M
Ito
Mitsugu
M
Yasuda
Hiroyoshi
H
Ota
Ken
K
Haruma
D000328:Adult; D000368:Aged; D001647:Bile Acids and Salts / Q000009:adverse effects / Q000378:metabolism; D001655:Bile Reflux / Q000150:complications* / Q000175:diagnosis; D016022:Case-Control Studies; D015331:Cohort Studies; D016001:Confidence Intervals; D005260:Female; D005753:Gastric Mucosa / Q000473:pathology; D005757:Gastritis, Atrophic / Q000209:etiology / Q000473:pathology*; D005773:Gastroscopy / Q000379:methods; D016481:Helicobacter Infections / Q000150:complications / Q000473:pathology*; D016480:Helicobacter pylori / Q000302:isolation & purification*; D006801:Humans; D015994:Incidence; D007413:Intestinal Mucosa / Q000473:pathology*; D007564:Japan; D008297:Male; D008679:Metaplasia / Q000453:epidemiology / Q000473:pathology; D008875:Middle Aged; D016017:Odds Ratio; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment; D013270:Stomach; D013274:Stomach Neoplasms / Q000453:epidemiology / Q000209:etiology / Q000473:pathology*
D001647:Bile Acids and Salts
Helicobacter pylori; atrophic gastritis; bile acid reflux; intestinal metaplasia