Changes in the Gastric Mucosa With Aging.
OBJECTIVE
We aimed to characterize age-related changes in the gastric mucosa and investigate the contribution of Helicobacter pylori infection to these changes.


METHODS
We collected data from a large national pathology database of 895,323 subjects who underwent esophagogastroduodenoscopy with gastric biopsies from January 2008 through December 2013 at endoscopy centers throughout the United States. The prevalence of various types of gastric histopathology was expressed as percent of the total study population, stratified by sex, age, and state.


RESULTS
Over a lifetime, the gastric mucosa became abnormal in 50% of subjects. A higher proportion of people in areas with a high prevalence of H pylori infection acquired gastric abnormalities. H pylori-associated chronic active gastritis and mucosal changes caused by infection were observed in 22% of biopsies; these were the most common gastric abnormalities observed. Reactive gastropathy, which was detected in 18% of biopsies, increased with age and was the second most common factor of gastric pathology observed.


CONCLUSIONS
On the basis of an analysis of biopsies collected by esophagogastroduodenoscopy in the United States, gastric abnormalities increase with age. Most pathologic conditions detected by histologic analysis are caused by H pylori infection, but the causes of many others are unknown.
Miraca Life Sciences, Research Institute, Irving, Texas; Department of Medicine, Oregon Health and Sciences University, Portland, Oregon. Electronic address: sonnenbe@ohsu.edu.
Amnon
A
Sonnenberg
Miraca Life Sciences, Research Institute, Irving, Texas; University of Texas Southwestern Medical Center, Dallas, Texas.
Robert M
RM
Genta
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D005260:Female; D005753:Gastric Mucosa / Q000033:anatomy & histology* / Q000473:pathology*; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D013270:Stomach / Q000033:anatomy & histology* / Q000502:physiology*; D013272:Stomach Diseases / Q000453:epidemiology* / Q000473:pathology*; D014481:United States; D055815:Young Adult
Epidemiology; Gastric Atrophy; Gastritis; Helicobacter pylori; Intestinal Metaplasia