The effects of chronic bile reflux on the gastric mucosa of rats

Wang, Xuewei; Tang, Jianmin; Cao, Qing

doi:10.4318/tjg.2013.0580

Cited by 7 publications

(5 citation statements)

References 42 publications

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“…High bile acid concentrations in gastric juice were found to be related to an increased risk of intestinal metaplasia 12 . Wang et al reported that chronic bile reflux can cause significant glandular gastric hyperplasia and gastric glandular dilatation and promote the formation of GC, and that intestinal metaplasia and ulcers in the glandular stomach are rare 29 . However, many clinical trials include small sample sizes and are only limited to chronic gastritis or intestinal metaplasia.…”

Section: Discussionmentioning

confidence: 99%

The relationship between gastric cancer, its precancerous lesions and bile reflux: A retrospective study

Zhang

Yao

et al. 2020

J of Digest Diseases

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Objective: To evaluate the relationship between gastric cancer (GC) and precancerous lesions and bile reflux.Methods: Medical records of 30 465 participants who underwent gastroscopy between January and December 2018 in our center were reviewed. Their age, sex, time of endoscopy, endoscopic/histologic diagnosis and grade of bile reflux were recorded. The participants were further divided into the chronic gastritis group (n = 27 807), a precancerous lesion group (n = 1943) and a GC group (n = 715). The χ 2 tests and hierarchical analyses were performed.Results: Patients aged 18-27 years had a higher bile reflux rate than those aged 28-37 and 68-75 years (P < 0.001), while it did not differ between patients aged <50 years and those over 50 years (P = 0.639). It was lower in men than in women (P < 0.001). The bile reflux rate did not differ in terms of months, seasons and half of the year (all P > 0.05), but differed between morning and afternoon when they underwent the endoscopy (P = 0.000). There was an interrelationship between the severity of gastric mucosal disease and bile reflux grade (r = 0.171). After excluding the effects of sex, age and time of endoscopy on bile reflux, bile reflux rate in chronic gastritis and precancerous lesions was lower than in gastric cancer (P < 0.01).Conclusions: Bile reflux may be a risk factor for gastric cancer and precancerous lesions. A high grade of bile reflux may be associated with the progression of gastric mucosal diseases.bile reflux, gastric neoplasms, gastritis, intestinal metaplasia, precancerous lesions | INTRODUCTIONAs the fifth most common malignant tumor worldwide, more than one million new cases of gastric cancer (GC) were estimated to be diagnosed in 2018; while the cancer-related mortality rate of GC is the third highest (equivalent to one in every 12 deaths worldwide). 1 In China the incidence and mortality of GC are also high. 2 According to the Correa model, despite its complex etiology GC usually begins with atrophic gastritis, intestinal metaplasia or atypical hyperplasia, and progresses to carcinogenesis. 3 Helicobacter pylori (H. pylori) infection, patient's age, sex, * These authors contributed equally to this work.

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Section: Discussionmentioning

confidence: 99%

The relationship between gastric cancer, its precancerous lesions and bile reflux: A retrospective study

Zhang

Yao

et al. 2020

J of Digest Diseases

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“…However, the histological features of primary BRG remain controversial. Wang et al [ 13 ] reported that foveolar hyperplasia existed in both the gastric corpora and gastric antrum with mild chronic inflammation in a rat model of long-term bile reflux, which is consistent with the pathological features of reflux gastritis. Bile reflux is known to be associated with the development of intestinal metaplasia in adult [ 5 , 12 ], but the relationship between bile reflux and intestinal metaplasia in children remains unclear.…”

Section: Discussionmentioning

confidence: 57%

Histological features of the gastric mucosa in children with primary bile reflux gastritis

Zhang

Yang

et al. 2012

World J Surg Onc

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BackgroundBile reflux is one of the primary factors involved in the pathogenesis of gastric mucosal lesions in patients with chronic gastritis; however, little is known about the exact histological features of bile reflux and its contributions to gastric mucosal lesions in this disease, especially in children with primary bile reflux gastritis (BRG). The aim of this study was to investigate the classic histological changes of the gastric mucosa in children with primary BRG.MethodsThe Bilitec 2000 was used for 24 h monitoring of gastric bile in 59 children with upper gastrointestinal symptoms. The histological characteristics of the gastric mucosa were examined and scored.ResultsThirteen of the 59 patients had a helicobacter pylori infection and were excluded; therefore, 46 cases were included in this study. The positive rate of pathological duodenogastric reflux was significantly higher in patients with foveolar hyperplasia than those without foveolar hyperplasia; however, the rate was significantly lower in patients with vascular congestion than those without vascular congestion. The longest reflux time and the total percentage time of bile reflux were significantly lower in patients with vascular congestion than those without vascular congestion. A total of 9 types of histological changes were analyzed using a binary logistic regression. Foveolar hyperplasia and vascular congestion in the superficial layer became significant variables in the last step of the stepwise regression.ConclusionsFoveolar hyperplasia was associated with the severity of bile reflux, suggesting that it is a histological feature of primary BRG in children, while vascular congestion may be a protective factor.

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“…The characteristic histological features of BRG, including antral foveolar hyperplasia, vascular congestion, edema, smooth muscle fibers in the lamina propria, and a paucity of inflammatory cells, were identified in adults. Nevertheless, the histological findings of gastric mucosa in children with BRG remain unclear [1,19] . Zhang et al [2] reported that foveolar hyperplasia is associated with the degree of bile reflux and may serve as the characteristic histological change of primary BRG in children.…”

Section: Discussionmentioning

confidence: 99%

Is there any relation between the presence of Helicobacter Pylori infection and duodenogastric reflux in children?

Bayrak¹

2023

Haydarpasa Numune Med J

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Introduction: Although it is a bile-sensitive microorganism in vitro, Helicobacter pylori (Hp) has been detected in human bile and gallbladder tissue. Recently, it is reported that bile acids eliminate Hp after gastric surgery. However, the data about the relationship between Hp and bile acids in subjects without surgery are limited. We aimed to evaluate the clinical features and Hp gastritis rate among patients with and without reflux of gastric bile acid. Methods: Patient data were collected through reviewing medical records of 1-18-years old children who underwent gastroscopy during the study period. The rapid urease test (RUT) result, the presence of gastric or bulbar erosion/ulcer, and duodenogastric reflux (DGR) were obtained from gastroscopy reports. Histologic changes of alkaline gastritis and other types of gastritis were noted. Hp infection was accepted as "present" if both RUT and histopathological findings confirm the Hp presence. Results: Among 754 diagnostic esophago-gastro-duodenoscopy (EGD), 521 subjects were eligible. Bile was visible at the stomach in 114 children (mean age: 11.29±3.90 years, 76.3% girls). The remaining 407 children without bile in the stomach were served as controls (mean age: 9.09±4.53 years, 52.1% girls). Girl gender was a risk factor for bile in the stomach during EGD (aOdds Ratio [aOR]: 1.33, 95% confidence interval [CI]: 1.09-1.77, p<0.05). Hp was present in 35 (30.7%) subjects in the study group and 210 (51.6%) controls (OR: 1.68, 95% CI: 1.25-2.24, p<0.05). Foveolar hyperplasia was present in 98 (86.0%) cases in the study group and 2 (0.5%) controls. Alkaline gastritis was correlated with bile in the stomach (r 2 : 0.89, p<0.01), older age (r 2 : 0.18, p<0.01), and girl gender (r 2 : 0.21, p<0.01). Discussion and Conclusion:The rate of Hp infection was lower in patients with DGR compared to controls. Furthermore, DGR was significantly more frequent in girls and grown-up children. A high percentage of patients with bile reflux had alkaline gastritis.

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The effects of chronic bile reflux on the gastric mucosa of rats

Cited by 7 publications

References 42 publications

The relationship between gastric cancer, its precancerous lesions and bile reflux: A retrospective study

The relationship between gastric cancer, its precancerous lesions and bile reflux: A retrospective study

Histological features of the gastric mucosa in children with primary bile reflux gastritis

Is there any relation between the presence of Helicobacter Pylori infection and duodenogastric reflux in children?

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