Chronic Gastritis: Helicobacter pylori Infection : A Clinico-Endoscopic and Histological evaluation

Singh Ranbeer; Taneja Vijay Laxmi; Verma K S; Dung R

Volume : VI, Issue : II, February - 2017

Chronic Gastritis: Helicobacter pylori Infection : A Clinico-Endoscopic and Histological evaluation

Singh Ranbeer, Taneja Vijay Laxmi, Verma K S, Dung R

Abstract :

Aims : To determine that H. pylori is a major etiologic organism in the pathogenesis of chronic gastritis, peptic ulcer disease and the development of gastric carcinoma and lymphoma. To study the comparative role of endoscopy and histopathology in the evaluation of patients with chronic gastritis and assess the graded variables of Helicobacter associated gastritis.

Methods: This study was conducted on 106 patients presented with clinical complaints pertaining that of chronic gastritis. Endoscopic examination as well as biopsy specimens from gastric mucosa were studied in all the cases for the various mucosal lesions observed in patients of chronic gastritis, and prevalence of H. pylori colonization has been established.

Results: On endoscopy we observed normal looking mucosa in 24 cases (22.64%), erythema/hyperemia in 50 (47.17%) cases, erosions in 11 (10.37%) patients, ulcerations in 06 (5.66%) patients, nodularity in 04 (3.77%) and mucosal atrophy as well as rugal hyperplasia were detected in 06 (5.66%) and 05 (4.73%) patients respectively. So endoscopic gastritis was observed in 82 (77.36%) cases out of total 106 cases. Histologically, we observed mononuclear inflammatory cellular infiltrates in 100 (94.34%) cases, out of total 106 patients of chronic gastritis included in this study, while 6 (5.66%) cases did not show any infiltrate. As far as the intensity (inflammation) of these infiltrates is concerned we observed - Grade 0 gastritis - Absent inflammation in 6 cases (6.00%), Grade 1 gastritis -Mild inflammation in 66 (66%) cases, Grade 2 gastritis - Moderate inflammation in 17 (17%) patients and Grade 3 gastritis -Severe inflammation in 11 (11%) patients. Histologically gastritis was detected in 100 cases out of total 106 patients. Apart from this, we observed, lymphoid follicles with germinal centre formation in 8 cases, active inflammation with neutrophil infiltration in 12 cases, mucosal glandular atrophy in 9 cases, intestinal metaplasia in 3 and dyplasia in 2 cases respectively.

Conclusion:

H. pylori associated gastritis is the predominant type of gastritis. It is concluded that H. pylori colonization was found in the majority of the biopsies, and the accurate endoscopic and histopathological examination of gastritis according to the Sydney grading system is a valuable indicator of H. pylori infection.