Skip to main content
Gut logoLink to Gut
. 1985 Jan;26(1):95–100. doi: 10.1136/gut.26.1.95

Histological appearances of oesophagus, antrum and duodenum and their correlation with symptoms in patients with a duodenal ulcer.

R J Earlam, J Amerigo, T Kakavoulis, D J Pollock
PMCID: PMC1432390  PMID: 3965370

Abstract

Clinical data and histology from the oesophagus, gastric antrum, and duodenum were collected from 36 patients undergoing surgery for duodenal ulcer. Gastritis was present in 94% of the patients (25% of atrophic type), oesophagitis in 72% and duodenitis in 39%. Abnormal biopsies were present from all three sites in 33% of the patients. Only one patient showed three normal biopsies. The low incidence of duodenitis does not support the theory that duodenitis is part of the same spectrum as duodenal ulcer. Heartburn was related to the presence of gastritis (100%) and oesophagitis (76%) but not to duodenitis (52%). No relationship was found between the length of history, severity of pain, and histological abnormalities.

Full text

PDF
95

Images in this article

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Brooks W. S., Wenger J., Hersh T. Bile reflux gastritis. Analysis of fasting and postprandial gastric aspirates. Am J Gastroenterol. 1975 Oct;64(4):286–291. [PubMed] [Google Scholar]
  2. Cheli R., Giacosa A. Inflammatory cell count and identification in chronic non specific duodenitis. Endoscopy. 1977 May;9(2):91–95. doi: 10.1055/s-0028-1098496. [DOI] [PubMed] [Google Scholar]
  3. Cotton P. B., Price A. B., Tighe J. R., Beales J. S. Preliminary evaluation of "duodenitis" by endoscopy and biopsy. Br Med J. 1973 Aug 25;3(5877):430–433. doi: 10.1136/bmj.3.5877.430. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Earlam R. A computerized questionnaire analysis of duodenal ulcer symptoms. Gastroenterology. 1976 Aug;71(2):314–317. [PubMed] [Google Scholar]
  5. Earlam R. Bile reflux and the Roux en Y anastomosis. Br J Surg. 1983 Jul;70(7):393–397. doi: 10.1002/bjs.1800700702. [DOI] [PubMed] [Google Scholar]
  6. Eastwood G. L. Effect of pH on bile salt injury to mouse gastric mucosa. A light- and electron-microscopic study. Gastroenterology. 1975 Jun;68(6):1456–1465. [PubMed] [Google Scholar]
  7. Fischer A. B., Graem N., Christiansen L. A. Causes and clinical significance of gastritis following Billroth II resection for duodenal ulcer. Br J Surg. 1983 Jun;70(6):322–325. doi: 10.1002/bjs.1800700606. [DOI] [PubMed] [Google Scholar]
  8. Fischer A. B., Graem N., Jensen O. M. Risk of gastric cancer after Billroth II resection for duodenal ulcer. Br J Surg. 1983 Sep;70(9):552–554. doi: 10.1002/bjs.1800700915. [DOI] [PubMed] [Google Scholar]
  9. Gear M. W., Truelove S. C., Whitehead R. Gastric ulcer and gastritis. Gut. 1971 Aug;12(8):639–645. doi: 10.1136/gut.12.8.639. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Hasan M., Sircus W., Ferguson A. Duodenal mucosal architecture in non-specific and ulcer-associated duodenitis. Gut. 1981 Aug;22(8):637–641. doi: 10.1136/gut.22.8.637. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Ismail-Beigi F., Horton P. F., Pope C. E., 2nd Histological consequences of gastroesophageal reflux in man. Gastroenterology. 1970 Feb;58(2):163–174. [PubMed] [Google Scholar]
  12. Joffe S. N., Lee F. D., Blumgart L. H. Duodenitis. Clin Gastroenterol. 1978 Sep;7(3):635–650. [PubMed] [Google Scholar]
  13. Johnson L. F., Demeester T. R., Haggitt R. C. Esophageal epithelial response to gastroesophageal reflux. A quantitative study. Am J Dig Dis. 1978 Jun;23(6):498–509. doi: 10.1007/BF01072693. [DOI] [PubMed] [Google Scholar]
  14. Kreuning J., Bosman F. T., Kuiper G., Wal A. M., Lindeman J. Gastric and duodenal mucosa in 'healthy' individuals. An endoscopic and histopathological study of 50 volunteers. J Clin Pathol. 1978 Jan;31(1):69–77. doi: 10.1136/jcp.31.1.69. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Schrumpf E., Serck-Hanssen A., Stadaas J., Aune S., Myren J., Osnes M. Mucosal changes in the gastric stump 20-25 years after partial gastrectomy. Lancet. 1977 Sep 3;2(8036):467–469. doi: 10.1016/s0140-6736(77)91599-9. [DOI] [PubMed] [Google Scholar]
  16. Schulze S., Thorsgaard Pedersen N., Jørgensen M. J., Møllmann K. M., Rune S. J. Association between duodenal bulb ulceration and reduced exocrine pancreatic function. Gut. 1983 Sep;24(9):781–783. doi: 10.1136/gut.24.9.781. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Seefeld U., Krejs G. J., Siebenmann R. E., Blum A. L. Esophageal histology in gastroesophageal reflux. Morphometric findings in suction biopsies. Am J Dig Dis. 1977 Nov;22(11):956–964. doi: 10.1007/BF01076193. [DOI] [PubMed] [Google Scholar]
  18. Stephen J. G., Lesna M., Venables C. W. Endoscopic appearances and histological changes in ulcer-associated duodenitis. Br J Surg. 1978 Jun;65(6):438–441. doi: 10.1002/bjs.1800650620. [DOI] [PubMed] [Google Scholar]
  19. Thompson H., Holme G. Proceedings: The diagnosis of duodenitis. Gut. 1974 Oct;15(10):842–843. [PubMed] [Google Scholar]
  20. Volpicelli N. A., Yardley J. H., Hendrix T. R. The association of heartburn with gastritis. Am J Dig Dis. 1977 Apr;22(4):333–339. doi: 10.1007/BF01072191. [DOI] [PubMed] [Google Scholar]
  21. Weinstein W. M., Bogoch E. R., Bowes K. L. The normal human esophageal mucosa: a histological reappraisal. Gastroenterology. 1975 Jan;68(1):40–44. [PubMed] [Google Scholar]
  22. Whitehead R., Roca M., Meikle D. D., Skinner J., Truelove S. C. The histological classification of duodenitis in fibreoptic biopsy specimens. Digestion. 1975;13(3):129–136. doi: 10.1159/000197701. [DOI] [PubMed] [Google Scholar]
  23. Whitehead R., Truelove S. C., Gear M. W. The histological diagnosis of chronic gastritis in fibreoptic gastroscope biopsy specimens. J Clin Pathol. 1972 Jan;25(1):1–11. doi: 10.1136/jcp.25.1.1. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Winter H. S., Madara J. L., Stafford R. J., Grand R. J., Quinlan J. E., Goldman H. Intraepithelial eosinophils: a new diagnostic criterion for reflux esophagitis. Gastroenterology. 1982 Oct;83(4):818–823. [PubMed] [Google Scholar]
  25. Wright R. A., Hurwitz A. L. Relationship of hiatal hernia to endoscopically proved reflux esophagitis. Dig Dis Sci. 1979 Apr;24(4):311–313. doi: 10.1007/BF01296546. [DOI] [PubMed] [Google Scholar]
  26. de Moraes-Filho J. P. Lack of specificity of the acid perfusion test in duodenal ulcer patients. Am J Dig Dis. 1974 Sep;19(9):785–790. doi: 10.1007/BF01071936. [DOI] [PubMed] [Google Scholar]

Articles from Gut are provided here courtesy of BMJ Publishing Group

RESOURCES