Gastric Secretion and Gastric Mucosal Morphology in Chronic Alcoholics

Abstract

Four to eight weeks after the cessation of alcohol intake, 70 alcoholics underwent gastric biopsies, gastric analysis, pancreozyminsecretin test, and liver biopsy. Biopsies revealed gastritis in 50% of body specimens and in 84% from the antrum. Correlation of biopsies with acid secretion revealed that maximal acid output (MAO) was 4.63 mEq/hr in atrophic gastritis, 22.40 mEq/hr in superficial gastritis and 26.97 mEq/hr in those with normal mucosa. There was no correlation between MAO and liver biopsy findings or pancreatic exocrine function. In 12 patients with gastritis studied serially during abstinence up to nine months, four showed increases in MAO which paralleled histological improvement. Our observations indicate that chronic alcohol ingestion is associated with an increased incidence of gastritis. In a significant percentage of these patients, mucosal recovery follows abstinence or adequate nutrition, or both.Pevious studies in chronic al¬ coholics and in patients with dis¬ eases associated with excessive alco¬ hol intake such as cirrhosis or pancreatitis have demonstrated de¬ rangement of gastric secretory func¬ tion or structure of the gastric mu¬ cosa, or both. Several groups of investigators1"1 reported a high inci¬ dence of gastritis in chronic alcoholics and some reported hyposecretion of acid in alcoholic subjects with cir¬ rhosis45 or chronic pancreatitis.6 Normal 31 (50.0%) 24 (85.7%)S uperficial gastritis_16 (25.8%)_3 (10.7%) Atrophie gastritis_15 (24.2%) _1 ( 3.6%)However, correlative studies between mucosal histology and acid secretion were not done in any of these reports.In a recent study7 we demonstrated a decrease in basal and maximal acid output in response to histamine ad¬ ministration and a high incidence of superficial and atrophie gastritis in a group of chronic alcoholics and in pa¬ tients with chronic pancreatitis asso¬ ciated with alcoholism. In the present communication, we extended our ob¬ servations on gastric secretory func¬ tion and gastric mucosal histology in 70 alcoholics and followed changes in these areas serially over a period of up to nine months in a limited num¬ ber of patients after the cessation of alcohol intake. Since the liver8·9 and the exocrine pancreatic function1011 have been shown previously to influ¬ ence gastric secretion of acid in dogs, we evaluated also the histology and function of the liver and pancreatic exocrine secretion. Materials and Methods

Effect of Alcohol Consumption on the Risk of <i>Helicobacter pylori </i>Infection

“…the mucosal injury found in the majority of alcoholics [6][7][8]. In some studies an increased incidence of chronic gastritis in alcoholics has been dem onstrated [6,9] whereas other studies [8,10] did not reveal any evidence of alcohol play ing a role in the etiology of chronic gastritis. Furthermore, no association between alcohol consumption and the prevalence of peptic ulceration has been found [11,12].…”

Pathologic basis of gastric mucosal adaptation to topical injury

“…3~ An improvement in histological gastritis was noted in 12 alcoholics following up to 9 months of abstinence from alcohol. 31 On the other hand, Brown et al 32 reported that chronic gastritis in patients with alcoholic cirrhosis was not higher than in controls. There is no doubt that alcohol abuse causes acute damage to the gastric mucosa, including hemorrhagic erosions after the ingestion of concentrated alcohol, although these lesions heal rapidly.…”

Alcohol and Gastric Mucosa

“…The observations of D ionoso el al. [16] indi cated clearly that chronic ethanol ingestion is associated with an increas ed incidence of superficial and atrophic gastritis, and that the MAO in chronic alcoholics depends on the mucosal histology of the body of the stomach. 2…”

“…In spite of the observations made by these investigators [8,28,34], it is still difficult to assess the role of ethanol in the development of atrophic gastritis in chronic alcoholics, since many of these alcoholics were undernourished or malnourished when the observations were made. Recently, Dinoso et al [16] investigated 70 male chronic alcoholics who were admitted to a rehabilitation center for treat ment of alcoholism. Gastric acid secretory study and histological study of the gastric mucosa were performed.…”

“…In 32 subjects from whom antral mucosa was obtained, atrophic gastritis was observed in 21 (65.6%), superficial gastritis in 6 (18.8%), and normal mucosa in 5 (15.6%). Furthermore, D inoso et al [16] observed that superficial or atrophic gastritis of the body Chronic Gastritis of the stomach was always associated with histologic changes in the antral mucosa, which include atrophic gastritis or superficial gastritis. In 28 con trol subjects, normal mucosa of the body of the stomach was observed in 24 (85.7%), superficial gastritis in 3 (10.7%), and atrophic gastritis in 1 (3.7%).…”