Morphological characteristics of reflux gastritis

Aim. To study morphological features of gastric mucosa in duodenogastric reflux and the connection of the latter with the level of acidity of gastric contents, presence of H. pylori infection and contractile function of the gallbladder.

Methods. 65 patients were examined: 10 people were included in control group, and in 55 patients reflux gastritis was identified according to gastrointestinal endoscopy. Gastric contents were analyzed for the level of acidity and concentration of bile acids. For all patients histological examination of biopsy material of gastric mucosa at the level of the body and antrum was performed.

Results. Correlation between the acidity level and the concentration of bile acids in gastric contents taken from an empty stomach was found (r=-0.408; p=0.033). In patients with H. pylori pH-level was higher compared to the control group (p=0.047), at the same time the level of bile acids had no significant difference in both groups. Discharge coefficient of the gallbladder in patients with duodenogastric reflux did not differ from the control group. In patients with duodenogastric reflux significant differences from the control group were found in the rate of such morphological signs as chronic inflammatory cell infiltration (p=0.013) and mucosal edema (p=0.032) at the level of the antrum, foveolar hyperplasia at the level of the body of the stomach (p=0.0315).

Conclusion. The degree of duodenogastric reflux has a correlation with acidity of gastric juice; presence or absence of H. pylori does not affect the degree of duodenogastric reflux in primary reflux gastritis; pathomorphological features of duodenogastric reflux are gastric mucosa edema and chronic inflammation at the level of the antrum, foveolar hyperplasia at the level of the body of stomach.