Volume : 6, Issue : 2, February - 2017

Chronic Gastritis: Helicobacter pylori Infection : A Clinico-Endoscopic and Histological evaluation

Singh Ranbeer, Taneja Vijay Laxmi, Verma K S, Dung R

Abstract :

<p>&nbsp;<b><span lang="EN-IN" style="font-size:14.0pt;line-height:115%">Aims : </span></b><span lang="EN-IN" style="font-size: 14pt; line-height: 115%;">To determine that <b><i>H. pylori</i></b>&nbsp; is a major etiologic organism in the pathogenesis of chronic gastritis, peptic ulcer disease and the development of gastric carcinoma and lymphoma. To study the comparative &nbsp;&nbsp;role of endoscopy and histopathology in the evaluation of patients with chronic gastritis and assess the graded variables of <b><i>Helicobacter</i></b> associated gastritis.</span></p> <p class="MsoNormal"><b><span lang="EN-IN" style="font-size:14.0pt;line-height:115%">&nbsp;&nbsp; Methods: </span></b><span lang="EN-IN" style="font-size:14.0pt;line-height:115%">This study was conducted on 106 patients presented with clinical complaints pertaining that of chronic gastritis.<b> </b>Endoscopic examination as well as biopsy &nbsp;specimens from gastric mucosa were studied in all the cases for the various mucosal lesions observed in patients of chronic gastritis, and prevalence of H. pylori colonization has been established.<o:p></o:p></span></p> <p class="MsoNormal"><b><span lang="EN-IN" style="font-size:14.0pt;line-height:115%">Results:&nbsp; <i>&nbsp;</i></span></b><span lang="EN-IN" style="font-size:14.0pt;line-height:115%">&nbsp;On endoscopy&nbsp; we observed normal looking mucosa&nbsp; in 24 cases (22.64%), erythema/hyperemia in 50 (47.17%) cases, erosions in 11 (10.37%) patients, ulcerations in 06 (5.66%) patients, nodularity in 04 (3.77%) and mucosal atrophy as well as rugal hyperplasia were detected in 06 (5.66%) and 05 (4.73%) patients respectively.&nbsp; So endoscopic gastritis was observed in 82&nbsp; (77.36%) cases out of total 106 cases. Histologically, we observed mononuclear inflammatory cellular infiltrates in 100 (94.34%) cases, out of total 106 patients of chronic gastritis included in this study, while&nbsp; 6&nbsp; (5.66%) cases did not show any infiltrate. As far as the intensity (inflammation) of these infiltrates is concerned we observed - Grade&nbsp; 0&nbsp; gastritis - Absent inflammation in 6 cases (6.00%), Grade 1 gastritis -Mild inflammation in 66 (66%) cases,&nbsp;&nbsp; Grade 2&nbsp; gastritis - Moderate inflammation in 17 (17%) patients and &nbsp;Grade 3&nbsp;&nbsp; gastritis -Severe inflammation in 11&nbsp; (11%) patients. Histologically gastritis was detected in 100 cases out of total 106 patients.&nbsp; Apart from this, we observed, lymphoid follicles with germinal centre formation in 8 cases, active inflammation with neutrophil infiltration in 12 cases, mucosal glandular atrophy in 9 cases, intestinal metaplasia in 3 and dyplasia&nbsp; in&nbsp; 2 cases respectively. <o:p></o:p></span></p> <p class="MsoNormal"><b><span lang="EN-IN" style="font-size:14.0pt;line-height:115%">Conclusion:<o:p></o:p></span></b></p> <p class="MsoNormal"><b><i><span lang="EN-IN" style="font-size:14.0pt;line-height:115%">&nbsp;&nbsp;&nbsp;&nbsp; H. pylori </span></i></b><span lang="EN-IN" style="font-size:14.0pt;&#10;line-height:115%">associated gastritis is the predominant type of gastritis. It is concluded&nbsp; that&nbsp; <b><i>H. pylori</i></b>&nbsp; colonization was found in the majority of the biopsies, and the accurate endoscopic and histopathological examination of gastritis according to the Sydney grading system is a valuable indicator of <b><i>H. pylori </i></b>infection.&nbsp; &nbsp;<o:p></o:p></span></p>