Abstract
The frequency of gastric Crohn's disease has been considered low. This study was undertaken to determine the prevalence of chronic gastritis and Helicobacter pylori infection in patients with Crohn's disease. Oesophagogastroduodenoscopy was performed on 62 consecutive patients suffering from ileocolonic Crohn's disease. Biopsy specimens from the antrum and corpus were processed for both histological and bacteriological examinations. H pylori antibodies of IgG and IgA classes were measured in serum samples by enzyme immunoassay. Six patients (9.7%) were infected with H pylori, as shown by histology, and in five of them the infection was also verified by serology. Twenty one patients (32%) had chronic H pylori negative gastritis (negative by both histology and serology) and one of them also had atrophy in the antrum and corpus. Granulomas were found in four patients. The characteristic appearance of H pylori negative gastritis was focal and mostly mild inflammation resembling the inflammatory changes seen in the gut in Crohn's disease. Patients with H pylori negative chronic gastritis had a significantly more active disease in their gut than those with normal gastric mucosa (p < 0.01). It is concluded that H pylori positive gastritis is rare, while H pylori negative gastritis is relatively common in patients with Crohn's disease. H pylori negative 'Crohn's gastritis' seems to be associated with active Crohn's disease.
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- Borody T. J., George L. L., Brandl S., Andrews P., Ostapowicz N., Hyland L., Devine M. Helicobacter pylori-negative duodenal ulcer. Am J Gastroenterol. 1991 Sep;86(9):1154–1157. [PubMed] [Google Scholar]
- Danzi J. T., Farmer R. G., Sullivan B. H., Jr, Rankin G. B. Endoscopic features of gastroduodenal Crohn's disease. Gastroenterology. 1976 Jan;70(1):9–13. [PubMed] [Google Scholar]
- Fielding J. F., Toye D. K., Beton D. C., Cooke W. T. Crohn's disease of the stomach and duodenum. Gut. 1970 Dec;11(12):1001–1006. doi: 10.1136/gut.11.12.1001. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Korelitz B. I., Waye J. D., Kreuning J., Sommers S. C., Fein H. D., Beeber J., Gelberg B. J. Crohn's disease in endoscopic biopsies of the gastric antrum and duodenum. Am J Gastroenterol. 1981 Aug;76(2):103–109. [PubMed] [Google Scholar]
- Kosunen T. U., Hök J., Rautelin H. I., Myllylä G. Age-dependent increase of Campylobacter pylori antibodies in blood donors. Scand J Gastroenterol. 1989 Jan;24(1):110–114. doi: 10.3109/00365528909092247. [DOI] [PubMed] [Google Scholar]
- Kosunen T. U., Seppälä K., Sarna S., Sipponen P. Diagnostic value of decreasing IgG, IgA, and IgM antibody titres after eradication of Helicobacter pylori. Lancet. 1992 Apr 11;339(8798):893–895. doi: 10.1016/0140-6736(92)90929-w. [DOI] [PubMed] [Google Scholar]
- Mashako M. N., Cezard J. P., Navarro J., Mougenot J. F., Sonsino E., Gargouri A., Maherzi A. Crohn's disease lesions in the upper gastrointestinal tract: correlation between clinical, radiological, endoscopic, and histological features in adolescents and children. J Pediatr Gastroenterol Nutr. 1989 May;8(4):442–446. [PubMed] [Google Scholar]
- McColl K. E., el-Nujumi A. M., Chittajallu R. S., Dahill S. W., Dorrian C. A., el-Omar E., Penman I., Fitzsimons E. J., Drain J., Graham H. A study of the pathogenesis of Helicobacter pylori negative chronic duodenal ulceration. Gut. 1993 Jun;34(6):762–768. doi: 10.1136/gut.34.6.762. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Myren J., Bouchier I. A., Watkinson G., Softley A., Clamp S. E., de Dombal F. T. The O.M.G.E. Multinational Inflammatory Bowel Disease Survey 1976-1982. A further report on 2,657 cases. Scand J Gastroenterol Suppl. 1984;95:1–27. [PubMed] [Google Scholar]
- Price A. B. The Sydney System: histological division. J Gastroenterol Hepatol. 1991 May-Jun;6(3):209–222. doi: 10.1111/j.1440-1746.1991.tb01468.x. [DOI] [PubMed] [Google Scholar]
- Rauws E. A., Langenberg W., Houthoff H. J., Zanen H. C., Tytgat G. N. Campylobacter pyloridis-associated chronic active antral gastritis. A prospective study of its prevalence and the effects of antibacterial and antiulcer treatment. Gastroenterology. 1988 Jan;94(1):33–40. [PubMed] [Google Scholar]
- Rutgeerts P., Onette E., Vantrappen G., Geboes K., Broeckaert L., Talloen L. Crohn's disease of the stomach and duodenum: A clinical study with emphasis on the value of endoscopy and endoscopic biopsies. Endoscopy. 1980 Nov;12(6):288–294. doi: 10.1055/s-2007-1021762. [DOI] [PubMed] [Google Scholar]
- Schmitz-Moormann P., Malchow H., Pittner P. M. Endoscopic and bioptic study of the upper gastrointestinal tract in Crohn's disease patients. Pathol Res Pract. 1985 Jan;179(3):377–387. doi: 10.1016/s0344-0338(85)80147-3. [DOI] [PubMed] [Google Scholar]
- Schrager J., Spink R., Mitra S. The antrum in patients with duodenal and gastric ulcers. Gut. 1967 Oct;8(5):497–508. doi: 10.1136/gut.8.5.497. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Sipponen P., Helske T., Järvinen P., Hyvärinen H., Seppälä K., Siurala M. Fall in the prevalence of chronic gastritis over 15 years: analysis of outpatient series in Finland from 1977, 1985, and 1992. Gut. 1994 Sep;35(9):1167–1171. doi: 10.1136/gut.35.9.1167. [DOI] [PMC free article] [PubMed] [Google Scholar]
- el-Omar E., Penman I., Cruikshank G., Dover S., Banerjee S., Williams C., McColl K. E. Low prevalence of Helicobacter pylori in inflammatory bowel disease: association with sulphasalazine. Gut. 1994 Oct;35(10):1385–1388. doi: 10.1136/gut.35.10.1385. [DOI] [PMC free article] [PubMed] [Google Scholar]