Abstract
Background: It has long been suspected that duodenogastric reflux plays a role in the pathogenesis
of intestinal metaplasia (IM), although recent studies have demonstrated a close association
between Helicobacter pylori infection and gastroduodenal diseases, including IM. The objective of this study
was to investigate the relation among IM and duodenogastric reflux, H pylori infection, and smoking. Methods: Subjects with “marked” characteristics of IM, all with extensive prepyloric distribution
at endoscopy that was confirmed histologically, were studied as an IM group (27 men,
26 women; mean age, 64 years). A control group was comprised by subjects without characteristics
of IM (29 men, 28 women; mean age, 63 years). Fasting pH, total bile acid concentration,
and ammonia concentration were measured in the gastric juice of all participants.
Histologic examination endoscopic biopsy specimens were evaluated histologically.
H pylori infection was determined by serum antibody and urease testing, and by histology.
Serum gastrin and pepsinogen concentrations, and gastric emptying time were measured.
Dietary, drinking, and smoking habits were recorded. Comparisons were made between
groups and analyzed statistically. Results: The pH and total bile acid concentrations were significantly higher in the IM group
than the control group (p < 0.01). No significant difference in H pylori infection was found between the IM and control group. Smoking was associated with
IM (odds ratio [OR], 15.74; 95% CI, 3.96 to 62.50). Conclusions: A high pH and total bile acid concentration and smoking were associated with “marked”
IM, suggesting that these factors may play a role in the development of IM. (Gastrointest
Endosc 2001;53:53-9.)
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Article info
Publication history
Accepted:
September 7,
2000
Received in revised form:
July 10,
2000
Received:
May 5,
2000
Footnotes
☆Supported in part by a Grant-in-Aid for Cancer Research from the Ministry of Health and Welfare of Japan.
☆☆Reprint requests: Ken Haruma, MD, First Department of Internal Medicine, Hiroshima University School of Medicine, 1-2-3, Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan.
★Gastrointest Endosc 2001;53:53-9
Identification
Copyright
© 2001 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.