Pattern of gastritis and duodenitis depending on the stage of gastroesophageal reflux disease associated with acid-related diseases


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Abstract

Background. Gastroesophageal reflux disease (GERD) is considered s a global medical problem. However, the state of the gastroduodenal (GD) mucous membrane (MM) in different stages of GERD comorbid with acid-dependent pathology, as well as some GD-associated dysfunctions require clarification. Objective. Identification of the relationship between the severity of gastritis and duodenitis and the state of esophageal MM in GERD associated with another acid-related pathology, and determine additional motor-secretory disorders for targeted therapy. Methods. In 2012-2017, 305 patients with GERD and comorbid duodenal ulcer, stomach ulcer and chronic pancreatitis were examined in the settings of the Kuban State Medical University. Study design: case series. All patients underwent esophagogastroduodenoscopy with biopsy of duodenum, antrum and body of the stomach; evaluation of gastric secretion and endoscopic manometry were performed in 145 patients, histological detection of Helicobacter pylori - in 84 patients. Results. Patients with stage C comorbid GERD compared with patients with non-erosive reflux disease (NERD) had more pronounced, statistically significant (p<0.001) gastritis manifestations according to endoscopic and histological criteria, as well as higher rates of inter-digestive HCl production (p<0.001). H. pylori Infection in the stomach body MM compared with its absence was accompanied by lower rates of interdigestive HCl secretion (p<0.001). Conclusion. In patients with GERD and comorbid acid-related diseases, syntropic histopathological changes in each of the sections of the GDMM (metaplasia and atrophy) are associated with the severity of reflux esophagitis, with basal gastric acid production and an increase in GD pressure not only in GERD, but also in NERD.

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About the authors

E. V Gorban

Kuban State Medical University

V. M Durleshter

Kuban State Medical University

N. V Korochanskaya

Kuban State Medical University

Vitaly V. Gorban

Kuban State Medical University

Email: gorbanvv@mai1.ru
MD, Head of the Department of Outpatient Therapy with the Course of GMP (FM) of the FATPRS

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