Analysis of gastroduodenitis and oesophagitis in relation to dyspeptic/reflux symptoms

Research output: Contribution to journalArticle

Abstract

Background/Aims: The pathogenesis of dyspeptic/reflux symptoms and the clinico-pathologic profile of affected patients are still poorly understood. To improve our knowledge in this field we carried out a systematic, comparative analysis of symptom profiles and histopathologic patterns of oesophagogastroduodenal mucosa in a series of 221 subjects, 140 with and 81 without endoscopie evidence of hiatal hernia. Of these, 190 showed reflux and/or dyspeptic symptoms. Methods: Before endoscopy, all the subjects were questioned about the presence and severity of 12 individual symptoms. Biopsies were taken from the distal oesophagus, cardia, corpus, angulus, antrum and duodenal bulb, and were scored in accordance with the Sydney system. Results: Patient groups with a distinct clinico-pathologic profile were better identified when symptoms of adequate severity were compared with histopathologic parameters. A correlation between gastroesophageal reflux disease (GORD) symptoms and histologie signs of oesophagitis was mostly restricted to patients endoscopically positive for oesophagitis. Retroxiphoid pyrosis correlated with cardial gastritis but not with oesophagitis, either endoscopie or histologie, while ulcer-like epigastric pain correlated with active duodenitis and distal gastritis. No definite histopathologic background was detected in patients with putative dysmotility-like symptoms, endoscopy-negative GORD and low score or mixed symptoms. Conclusion: A contribution of Helicobacter pylori gastroduodenitis to the pathogenesis of some dyspeptic symptoms seems likely. However, the identification of specific histologie changes causing individual symptoms remains rather elusive, with the exception of active antroduodenitis in patients with ulcer-like pain and of active proximal gastritis in patients with severe retroxiphoid pyrosis.

Original languageEnglish
Pages (from-to)91-101
Number of pages11
JournalDigestion
Volume59
Issue number2
Publication statusPublished - 1998

Keywords

  • Duodenitis dyspepsia
  • Gastritis
  • Gastroesophageal reflux symptoms
  • Oesophagitis

ASJC Scopus subject areas

  • Gastroenterology

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