Abstract
AIMS: To evaluate the prevalence and significance of chemical gastritis, in comparison with gastritis related to Helicobacter pylori in patients receiving non-steroidal anti inflammatory drugs (NSAIDs). METHODS: Two hundred and eighteen patients were studied, 174 of whom were taking NSAIDs. Chemical gastritis was defined as the presence of foveolar hyperplasia, muscle fibres in the lamina propria, oedema and vasodilation, in the absence of a chronic inflammatory cell infiltrate. RESULTS: Chemical gastritis was found in 46 (26%) patients taking NSAIDs, and three (7%) in subjects not taking these drugs (p less than 0.01). H pylori was detected in 56 (32%) subjects taking NSAIDs compared with 22 (50%) not taking these agents (p less than 0.02). Ulcers were found in 16 out of 72 patients (22%) taking NSAIDs and without H pylori infection or chemical gastritis compared with 27 out of 56 (48%) with H pylori related gastritis (p less than 0.01), and 25 out of 46 (54%) with chemical gastritis (p less than 0.01). CONCLUSIONS: Peptic ulcers associated with the use of NSAIDs seem to occur more commonly in patients with chemical gastritis or H pylori infection. Patients taking NSAIDs also seem to have a greater prevalence of chemical gastritis but a lower prevalence of H pylori than those not taking these drugs.
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- Cooke A. R. The role of the mucosal barrier in drug-induced gastric ulceration and erosions. Am J Dig Dis. 1976 Feb;21(2):155–164. doi: 10.1007/BF01072063. [DOI] [PubMed] [Google Scholar]
- Dixon M. F., O'Connor H. J., Axon A. T., King R. F., Johnston D. Reflux gastritis: distinct histopathological entity? J Clin Pathol. 1986 May;39(5):524–530. doi: 10.1136/jcp.39.5.524. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Dixon M. F., Wyatt J. I., Burke D. A., Rathbone B. J. Lymphocytic gastritis--relationship to Campylobacter pylori infection. J Pathol. 1988 Feb;154(2):125–132. doi: 10.1002/path.1711540204. [DOI] [PubMed] [Google Scholar]
- Drapanas T., Bethea M. Reflux gastritis following gastric surgery. Ann Surg. 1974 May;179(5):618–627. doi: 10.1097/00000658-197405000-00014. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 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]
- Graham D. Y., Agrawal N. M., Roth S. H. Prevention of NSAID-induced gastric ulcer with misoprostol: multicentre, double-blind, placebo-controlled trial. Lancet. 1988 Dec 3;2(8623):1277–1280. doi: 10.1016/s0140-6736(88)92892-9. [DOI] [PubMed] [Google Scholar]
- Graham D. Y., Smith J. L., Spjut H. J., Torres E. Gastric adaptation. Studies in humans during continuous aspirin administration. Gastroenterology. 1988 Aug;95(2):327–333. [PubMed] [Google Scholar]
- Greenlaw R., Sheahan D. G., DeLuca V., Miller D., Myerson D., Myerson P. Gastroduodenitis. A broader concept of peptic ulcer disease. Dig Dis Sci. 1980 Sep;25(9):660–672. doi: 10.1007/BF01308325. [DOI] [PubMed] [Google Scholar]
- Kauffman G. L., Jr, Aures D., Grossman M. I. Intravenous indomethacin and aspirin reduce basal gastric mucosal blood flow in dogs. Am J Physiol. 1980 Feb;238(2):G131–G134. doi: 10.1152/ajpgi.1980.238.2.G131. [DOI] [PubMed] [Google Scholar]
- Kent T. H., Cardelli R. M., Stamler F. W. Small intestinal ulcers and intestinal flora in rats given indomethacin. Am J Pathol. 1969 Feb;54(2):237–249. [PMC free article] [PubMed] [Google Scholar]
- Laine L., Weinstein W. M. Histology of alcoholic hemorrhagic "gastritis": a prospective evaluation. Gastroenterology. 1988 Jun;94(6):1254–1262. doi: 10.1016/0016-5085(88)90661-0. [DOI] [PubMed] [Google Scholar]
- MENGUY R., MASTERS Y. F. EFFECTS OF ASPIRIN ON GASTRIC MUCOUS SECRETION. Surg Gynecol Obstet. 1965 Jan;120:92–98. [PubMed] [Google Scholar]
- Marshall B. J., Warren J. R. Unidentified curved bacilli in the stomach of patients with gastritis and peptic ulceration. Lancet. 1984 Jun 16;1(8390):1311–1315. doi: 10.1016/s0140-6736(84)91816-6. [DOI] [PubMed] [Google Scholar]
- McNulty C. A., Watson D. M. Spiral bacteria of the gastric antrum. Lancet. 1984 May 12;1(8385):1068–1069. doi: 10.1016/s0140-6736(84)91469-7. [DOI] [PubMed] [Google Scholar]
- Menguy R., Desbaillets L. Role of inhibition of gastric mucous secretion in the phenomenon of gastric mucosal injury by indomethacin. Am J Dig Dis. 1967 Sep;12(9):862–866. doi: 10.1007/BF02236444. [DOI] [PubMed] [Google Scholar]
- Price A. B., Levi J., Dolby J. M., Dunscombe P. L., Smith A., Clark J., Stephenson M. L. Campylobacter pyloridis in peptic ulcer disease: microbiology, pathology, and scanning electron microscopy. Gut. 1985 Nov;26(11):1183–1188. doi: 10.1136/gut.26.11.1183. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Rainsford K. D., Willis C. Relationship of gastric mucosal damage induced in pigs by antiinflammatory drugs to their effects on prostaglandin production. Dig Dis Sci. 1982 Jul;27(7):624–635. doi: 10.1007/BF01297219. [DOI] [PubMed] [Google Scholar]
- Redfern J. S., Lee E., Feldman M. Effect of indomethacin on gastric mucosal prostaglandins in humans. Correlation with mucosal damage. Gastroenterology. 1987 Apr;92(4):969–977. doi: 10.1016/0016-5085(87)90972-3. [DOI] [PubMed] [Google Scholar]
- Rees W. D., Gibbons L. C., Turnberg L. A. Effects of non-steroidal anti-inflammatory drugs and prostaglandins on alkali secretion by rabbit gastric fundus in vitro. Gut. 1983 Sep;24(9):784–789. doi: 10.1136/gut.24.9.784. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Robert A., Asano T. Resistance of germfree rats to indomethacin-induced intestinal lesions. Prostaglandins. 1977 Aug;14(2):333–341. doi: 10.1016/0090-6980(77)90178-2. [DOI] [PubMed] [Google Scholar]
- Sarosiek J., Mizuta K., Slomiany A., Slomiany B. L. Effect of acetylsalicylic acid on gastric mucin viscosity, permeability to hydrogen ion, and susceptibility to pepsin. Biochem Pharmacol. 1986 Dec 1;35(23):4291–4295. doi: 10.1016/0006-2952(86)90708-2. [DOI] [PubMed] [Google Scholar]
- Sipponen P., Seppälä K., Aärynen M., Helske T., Kettunen P. Chronic gastritis and gastroduodenal ulcer: a case control study on risk of coexisting duodenal or gastric ulcer in patients with gastritis. Gut. 1989 Jul;30(7):922–929. doi: 10.1136/gut.30.7.922. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Sobala G. M., King R. F., Axon A. T., Dixon M. F. Reflux gastritis in the intact stomach. J Clin Pathol. 1990 Apr;43(4):303–306. doi: 10.1136/jcp.43.4.303. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Strickland R. G., Mackay I. R. A reappraisal of the nature and significance of chronic atrophic gastritis. Am J Dig Dis. 1973 May;18(5):426–440. doi: 10.1007/BF01071995. [DOI] [PubMed] [Google Scholar]
- Taha A. S., Boothman P., Holland P., McKinlay A., Upadhyay R., Kelly R. W., Lee F., Russell R. I. Gastric mucosal prostaglandin synthesis in the presence of Campylobacter pylori in patients with gastric ulcers and non-ulcer dyspepsia. Am J Gastroenterol. 1990 Jan;85(1):47–50. [PubMed] [Google Scholar]
- Taha A. S., Kelly R. W., Gemmell C. G., Lee F. D., Russell R. I. The interaction between Helicobacter pylori culture filtrate and indomethacin: effects on the integrity of human gastric antral mucosa and its prostaglandin E2 production in vitro. Aliment Pharmacol Ther. 1990 Jun;4(3):265–273. doi: 10.1111/j.1365-2036.1990.tb00471.x. [DOI] [PubMed] [Google Scholar]
- Taha A. S., McLaughlin S., Holland P. J., Kelly R. W., Sturrock R. D., Russell R. I. Effect on gastric and duodenal mucosal prostaglandins of repeated intake of therapeutic doses of naproxen and etodolac in rheumatoid arthritis. Ann Rheum Dis. 1990 Jun;49(6):354–358. doi: 10.1136/ard.49.6.354. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Upadhyay R., Howatson A., McKinlay A., Danesh B. J., Sturrock R. D., Russell R. I. Campylobacter pylori associated gastritis in patients with rheumatoid arthritis taking nonsteroidal anti-inflammatory drugs. Br J Rheumatol. 1988 Apr;27(2):113–116. doi: 10.1093/rheumatology/27.2.113. [DOI] [PubMed] [Google Scholar]
- 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]
- Whittle B. J., Higgs G. A., Eakins K. E., Moncada S., Vane J. R. Selective inhibition of prostaglandin production in inflammatory exudates and gastric mucosa. Nature. 1980 Mar 20;284(5753):271–273. doi: 10.1038/284271a0. [DOI] [PubMed] [Google Scholar]