title: The coeliac stomach: gastritis in patients with coeliac disease.
abstract: BACKGROUND
  Lymphocytic gastritis (LG) is an uncommon entity with varying symptoms and endoscopic appearances. This condition, as well as two forms of H. pylori-negative gastritis [chronic active gastritis (CAG) and chronic inactive gastritis (CIG)], appears to be more common in patients with coeliac disease (CD) based on single-centred studies.
  
  
  OBJECTIVE
  To compare the prevalence of LG, CAG and CIG among those with normal duodenal histology (or nonspecific duodenitis) and those with CD, as defined by villous atrophy (Marsh 3).
  
  
  METHODS
  We analysed all concurrent gastric and duodenal biopsy specimens submitted to a national pathology laboratory during a 6-year period. We performed multiple logistic regression to identify independent predictors of each gastritis subtype.
  
  
  RESULTS
  Among patients who underwent concurrent gastric and duodenal biopsy (n = 287,503), the mean age was 52 and the majority (67%) were female. Compared to patients with normal duodenal histology, LG was more common in partial villous atrophy (OR: 37.66; 95% CI: 30.16-47.03), and subtotal/total villous atrophy (OR: 78.57; 95% CI: 65.37-94.44). CD was also more common in CAG (OR for partial villous atrophy 1.93; 95% CI: 1.49-2.51, OR for subtotal/total villous atrophy 2.42; 95% CI: 1.90-3.09) and was similarly associated with CIG (OR for partial villous atrophy 2.04; 95% CI: 1.76-2.35, OR for subtotal/total villous atrophy 2.96; 95% CI: 2.60-3.38).
  
  
  CONCLUSIONS
  Lymphocytic gastritis is strongly associated with coeliac disease, with increasing prevalence correlating with more advanced villous atrophy. Chronic active gastritis and chronic inactive gastritis are also significantly associated with coeliac disease. Future research should measure the natural history of these conditions after treatment with a gluten-free diet.
authors.affiliation: Department of Medicine, Coeliac Disease Center, Columbia University College of Physicians and Surgeons, New York, NY, USA.|Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA.
authors.forename: B
authors.initials: B
authors.lastname: Lebwohl
authors.affiliation: Department of Medicine, Coeliac Disease Center, Columbia University College of Physicians and Surgeons, New York, NY, USA.
authors.forename: P H R
authors.initials: PH
authors.lastname: Green
authors.affiliation: Miraca Life Sciences, Irving, TX, USA.|Departments of Pathology and Medicine (Gastroenterology), UT Southwestern Medical Center, Dallas, TX, USA.
authors.forename: R M
authors.initials: RM
authors.lastname: Genta
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001284:Atrophy; D001706:Biopsy; D002446:Celiac Disease / Q000453:epidemiology* / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004382:Duodenitis / Q000453:epidemiology / Q000473:pathology; D005260:Female; D005756:Gastritis / Q000145:classification / Q000453:epidemiology* / Q000473:pathology*; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D013270:Stomach / Q000473:pathology; D055815:Young Adult