Gastroesophageal reflux disease versus Helicobacter pylori infection as the cause of gastric carditis

Yunn Yi Chen, Donald A. Antonioli, Stuart J. Spechler, John M. Zeroogian, Raj K. Goyal, Helen H. Wang

Research output: Contribution to journalArticle

60 Citations (Scopus)

Abstract

To explore the potential contributions of gastroesophageal reflux disease, as opposed to Helicobacter pylori infection, to the development of gastric carditis, we evaluated gastric carditis (using the criteria of the updated Sydney system for the classification of gastritis), clinical and morphologic features of esophagitis, and H. pylori infection (evaluation of Steiner stains) in biopsy specimens from the gastroesophageal squamocolumnar junction. We correlated clinical, endoscopic, and histologic features in an unselected group of 116 patients. Some degree of carditis was found in 107 (92%) of the patients. The mean age of the patients increased with increasing severity of carditis (P < .05). The various groups of patients with different degrees of carditis did not differ significantly in sex ratio, ethnic background, presence of obesity, percentage having symptoms of gastroesophageal reflux disease (such as heartburn, regurgitation, dysphagia, or odynophagia), endoscopic evidence of esophagitis and collar epithelium in the distal esophagus, or histologic evidence of active esophagitis. The presence, however, of active gastritis and H. pylori infection in the distal stomach and/or in the cardia was significantly associated with carditis. In patients without carditis, H. pylori was not detected in any cardiac or distal gastric biopsy specimen. In contrast, H. pylori was demonstrated in gastric tissue samples (either from the cardia or distally) of patients with carditis, with the prevalence rate increasing with greater degrees of cardiac inflammation. The H. pylori prevalence rate was 12% in the group with mild carditis, 40% in those with moderate carditis, and 57% in patients with marked carditis (P = .0001). In summary, carditis is commonly found in patients with symptoms related to upper gastrointestinal diseases. From analysis of our study cohort, we concluded that carditis was significantly associated with H. pylori infection and active gastritis but not with symptoms or signs of gastroesophageal reflux disease. These findings suggest that carditis with histologic features similar to those of gastritis in the distal stomach was a sequel of H. pylori infection and represented a part of an H. pylori-associated gastric inflammation.

Original languageEnglish (US)
Pages (from-to)950-956
Number of pages7
JournalModern Pathology
Volume11
Issue number10
StatePublished - Oct 1998

Fingerprint

Myocarditis
Helicobacter Infections
Gastroesophageal Reflux
Helicobacter pylori
Stomach
Gastritis
Esophagitis
Cardia
Inflammation
Biopsy
Esophagogastric Junction
Heartburn
Gastrointestinal Diseases
Sex Ratio
Deglutition Disorders
Esophagus
Signs and Symptoms
Cohort Studies
Coloring Agents
Epithelium

Keywords

  • Carditis
  • Gastritis
  • Gastroesophageal reflux disease
  • Helicobacter pylori infection

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

Cite this

Chen, Y. Y., Antonioli, D. A., Spechler, S. J., Zeroogian, J. M., Goyal, R. K., & Wang, H. H. (1998). Gastroesophageal reflux disease versus Helicobacter pylori infection as the cause of gastric carditis. Modern Pathology, 11(10), 950-956.

Gastroesophageal reflux disease versus Helicobacter pylori infection as the cause of gastric carditis. / Chen, Yunn Yi; Antonioli, Donald A.; Spechler, Stuart J.; Zeroogian, John M.; Goyal, Raj K.; Wang, Helen H.

In: Modern Pathology, Vol. 11, No. 10, 10.1998, p. 950-956.

Research output: Contribution to journalArticle

Chen, YY, Antonioli, DA, Spechler, SJ, Zeroogian, JM, Goyal, RK & Wang, HH 1998, 'Gastroesophageal reflux disease versus Helicobacter pylori infection as the cause of gastric carditis', Modern Pathology, vol. 11, no. 10, pp. 950-956.
Chen, Yunn Yi ; Antonioli, Donald A. ; Spechler, Stuart J. ; Zeroogian, John M. ; Goyal, Raj K. ; Wang, Helen H. / Gastroesophageal reflux disease versus Helicobacter pylori infection as the cause of gastric carditis. In: Modern Pathology. 1998 ; Vol. 11, No. 10. pp. 950-956.
@article{f743d2ea12ad433c817253f667921053,
title = "Gastroesophageal reflux disease versus Helicobacter pylori infection as the cause of gastric carditis",
abstract = "To explore the potential contributions of gastroesophageal reflux disease, as opposed to Helicobacter pylori infection, to the development of gastric carditis, we evaluated gastric carditis (using the criteria of the updated Sydney system for the classification of gastritis), clinical and morphologic features of esophagitis, and H. pylori infection (evaluation of Steiner stains) in biopsy specimens from the gastroesophageal squamocolumnar junction. We correlated clinical, endoscopic, and histologic features in an unselected group of 116 patients. Some degree of carditis was found in 107 (92{\%}) of the patients. The mean age of the patients increased with increasing severity of carditis (P < .05). The various groups of patients with different degrees of carditis did not differ significantly in sex ratio, ethnic background, presence of obesity, percentage having symptoms of gastroesophageal reflux disease (such as heartburn, regurgitation, dysphagia, or odynophagia), endoscopic evidence of esophagitis and collar epithelium in the distal esophagus, or histologic evidence of active esophagitis. The presence, however, of active gastritis and H. pylori infection in the distal stomach and/or in the cardia was significantly associated with carditis. In patients without carditis, H. pylori was not detected in any cardiac or distal gastric biopsy specimen. In contrast, H. pylori was demonstrated in gastric tissue samples (either from the cardia or distally) of patients with carditis, with the prevalence rate increasing with greater degrees of cardiac inflammation. The H. pylori prevalence rate was 12{\%} in the group with mild carditis, 40{\%} in those with moderate carditis, and 57{\%} in patients with marked carditis (P = .0001). In summary, carditis is commonly found in patients with symptoms related to upper gastrointestinal diseases. From analysis of our study cohort, we concluded that carditis was significantly associated with H. pylori infection and active gastritis but not with symptoms or signs of gastroesophageal reflux disease. These findings suggest that carditis with histologic features similar to those of gastritis in the distal stomach was a sequel of H. pylori infection and represented a part of an H. pylori-associated gastric inflammation.",
keywords = "Carditis, Gastritis, Gastroesophageal reflux disease, Helicobacter pylori infection",
author = "Chen, {Yunn Yi} and Antonioli, {Donald A.} and Spechler, {Stuart J.} and Zeroogian, {John M.} and Goyal, {Raj K.} and Wang, {Helen H.}",
year = "1998",
month = "10",
language = "English (US)",
volume = "11",
pages = "950--956",
journal = "Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc",
issn = "0893-3952",
publisher = "Nature Publishing Group",
number = "10",

}

TY - JOUR

T1 - Gastroesophageal reflux disease versus Helicobacter pylori infection as the cause of gastric carditis

AU - Chen, Yunn Yi

AU - Antonioli, Donald A.

AU - Spechler, Stuart J.

AU - Zeroogian, John M.

AU - Goyal, Raj K.

AU - Wang, Helen H.

PY - 1998/10

Y1 - 1998/10

N2 - To explore the potential contributions of gastroesophageal reflux disease, as opposed to Helicobacter pylori infection, to the development of gastric carditis, we evaluated gastric carditis (using the criteria of the updated Sydney system for the classification of gastritis), clinical and morphologic features of esophagitis, and H. pylori infection (evaluation of Steiner stains) in biopsy specimens from the gastroesophageal squamocolumnar junction. We correlated clinical, endoscopic, and histologic features in an unselected group of 116 patients. Some degree of carditis was found in 107 (92%) of the patients. The mean age of the patients increased with increasing severity of carditis (P < .05). The various groups of patients with different degrees of carditis did not differ significantly in sex ratio, ethnic background, presence of obesity, percentage having symptoms of gastroesophageal reflux disease (such as heartburn, regurgitation, dysphagia, or odynophagia), endoscopic evidence of esophagitis and collar epithelium in the distal esophagus, or histologic evidence of active esophagitis. The presence, however, of active gastritis and H. pylori infection in the distal stomach and/or in the cardia was significantly associated with carditis. In patients without carditis, H. pylori was not detected in any cardiac or distal gastric biopsy specimen. In contrast, H. pylori was demonstrated in gastric tissue samples (either from the cardia or distally) of patients with carditis, with the prevalence rate increasing with greater degrees of cardiac inflammation. The H. pylori prevalence rate was 12% in the group with mild carditis, 40% in those with moderate carditis, and 57% in patients with marked carditis (P = .0001). In summary, carditis is commonly found in patients with symptoms related to upper gastrointestinal diseases. From analysis of our study cohort, we concluded that carditis was significantly associated with H. pylori infection and active gastritis but not with symptoms or signs of gastroesophageal reflux disease. These findings suggest that carditis with histologic features similar to those of gastritis in the distal stomach was a sequel of H. pylori infection and represented a part of an H. pylori-associated gastric inflammation.

AB - To explore the potential contributions of gastroesophageal reflux disease, as opposed to Helicobacter pylori infection, to the development of gastric carditis, we evaluated gastric carditis (using the criteria of the updated Sydney system for the classification of gastritis), clinical and morphologic features of esophagitis, and H. pylori infection (evaluation of Steiner stains) in biopsy specimens from the gastroesophageal squamocolumnar junction. We correlated clinical, endoscopic, and histologic features in an unselected group of 116 patients. Some degree of carditis was found in 107 (92%) of the patients. The mean age of the patients increased with increasing severity of carditis (P < .05). The various groups of patients with different degrees of carditis did not differ significantly in sex ratio, ethnic background, presence of obesity, percentage having symptoms of gastroesophageal reflux disease (such as heartburn, regurgitation, dysphagia, or odynophagia), endoscopic evidence of esophagitis and collar epithelium in the distal esophagus, or histologic evidence of active esophagitis. The presence, however, of active gastritis and H. pylori infection in the distal stomach and/or in the cardia was significantly associated with carditis. In patients without carditis, H. pylori was not detected in any cardiac or distal gastric biopsy specimen. In contrast, H. pylori was demonstrated in gastric tissue samples (either from the cardia or distally) of patients with carditis, with the prevalence rate increasing with greater degrees of cardiac inflammation. The H. pylori prevalence rate was 12% in the group with mild carditis, 40% in those with moderate carditis, and 57% in patients with marked carditis (P = .0001). In summary, carditis is commonly found in patients with symptoms related to upper gastrointestinal diseases. From analysis of our study cohort, we concluded that carditis was significantly associated with H. pylori infection and active gastritis but not with symptoms or signs of gastroesophageal reflux disease. These findings suggest that carditis with histologic features similar to those of gastritis in the distal stomach was a sequel of H. pylori infection and represented a part of an H. pylori-associated gastric inflammation.

KW - Carditis

KW - Gastritis

KW - Gastroesophageal reflux disease

KW - Helicobacter pylori infection

UR - http://www.scopus.com/inward/record.url?scp=0031792382&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0031792382&partnerID=8YFLogxK

M3 - Article

C2 - 9796721

AN - SCOPUS:0031792382

VL - 11

SP - 950

EP - 956

JO - Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc

JF - Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc

SN - 0893-3952

IS - 10

ER -