Gut 1999;45:181-185 ( August )

Article

Corpus gastritis is protective against reflux oesophagitis H B El-Serag, A Sonnenberg, M M Jamal, J M Inadomi, L A Crooks, R M Feddersen

Department of Veterans Affairs Medical Centre, University of New Mexico, Albuquerque, New Mexico, USA

Correspondence to: Dr A Sonnenberg, Department of Veterans Affairs Medical Centre 111F, 1501 San Pedro Drive SE, Albuquerque, New Mexico 87108, USA.

Accepted for publication 13 January 1999

BACKGROUNDGastric acid is important in the pathogenesis of reflux oesophagitis. Acid production by the gastric corpus is reduced in corpus gastritis.
AIMSTo determine whether corpus gastritis protects against reflux oesophagitis.
METHODSPatients presenting for elective oesophagogastroduodenoscopy were studied. Two biopsy specimens were taken from the antrum, corpus, and cardia and stained with haematoxylin/eosin and Diff-Quick II stains. The presence and severity of gastritis were graded according to a modified updated Sydney classification.
RESULTSOf 302 patients, 154 had endoscopic signs of reflux oesophagitis. There was no difference between patients with and controls without oesophagitis in the overall infection rates with Helicobacter pylori. Acute or chronic corpus gastritis occurred less often in patients with than those without reflux oesophagitis. Compared with controls, corpus gastritis was less severe in patients with reflux oesophagitis. The presence of acute or chronic gastritis in the corpus was significantly correlated with either type of gastritis in other areas of the stomach. In a multivariate logistic regression, age, sex, smoking status, and the presence of chronic corpus gastritis all exerted a significant influence on the presence of reflux oesophagitis. Chronic corpus gastritis was associated with a 54% reduced risk for reflux oesophagitis.
CONCLUSIONSWhile infection with H pylori alone may not affect the occurrence of reflux oesophagitis, the development of chronic corpus gastritis seems to be protective.


Keywords: acid secretion; gastritis; gastro-oesophageal reflux disease; Helicobacter pylori; reflux oesophagitis; Sydney system

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