Peptic Ulcer Research Today is a free monthly online journal that collates and summarizes the latest research about Peptic Ulcer, including details on helicobacter pylori, diet, symptoms, treatment.

The pathology of gastric cardia: a prospective, endoscopic, and morphologic study.

Cestari R, Villanacci V, Bassotti G, Rossi E, Casa DD, Missale G, Minelli L, Cengia P, Gambarotti M, Pirali F, Donato F, Genta RM

Surgical Endoscopy Unit, Department of Clinical and Experimental Medicine, University of Perugia School of Medicine, Italy.

"Carditis" (inflammation of the gastric cardiac mucosa) may be associated with gastroesophageal reflux disease (GERD), whereas other studies argue that Helicobacter pylori could play a significant role in the chronic cardiac damage. We examined prospectively histologic features of gastric cardia, esophagitis, and H. pylori status in 204 consecutive subjects with GERD symptoms (57.3% male, 42.7% female mean age 49.2 y) undergoing upper gastrointestinal endoscopy with multiple biopsies in the distal esophagus, cardiac region, and stomach. These were assessed for esophagitis landmarks [Ismail Beigi grading (g0-3)], gastritis, and H. pylori infection (Sydney classification). The average symptom duration was 10.8 months. Endoscopy showed no erosive disease in 54.5% patients, grade "A" esophagitis in 37.6%, "B" in 8%, and "C" in 1 case. Histologic examination disclosed g0 in 8.3% patients, g1 in 78.4%, g2 in 12.8%, and g3 in 1; analysis of the cardia showed oxyntic mucosa in 27.9% patients and chronic cardiac mucosa inflammation in 72.1%. Carditis was significantly related to macroscopic esophagitis (P=0.044) and heartburn score (P=0.001). H. pylori cardiac infection was present in 27.4% cases (73.2% associated with cardiac mucosa). Gastric H. pylori infection was demonstrated in 35% patients. H. pylori in the cardiac region was associated with gastric H. pylori infection (P=0.001) and with paucity of GERD symptoms (P=0.05). A good correlation between carditis and GERD, concerning symptoms and macroscopic esophagitis was found in this study. H. pylori-related carditis is likely to be differently compared with the GERD-related type.

Published 26 April 2007 in Am J Surg Pathol, 31(5): 706-10.
Full-text of this article is available online (may require subscription).

© 2004-2008 Peptic Ulcer Research Today. All Rights Reserved.