Abstract
The incidence and relationship of intestinal metaplasia of the gastric antrum and gastric metaplasia of the first part of the duodenum were studied in endoscopic biopsies from 120 patients with nonulcer dyspepsia. Intestinal metaplasia was present in 29% of antral biopsies and gastric metaplasia in 39% of duodenal biopsies, with 9% of patients having both. Intestinal metaplasia was not related to alcohol consumption, but was significantly higher in patients who smoked 10 cigarettes or more daily. (P<0.002). Gastric metaplasia was associated with duodenitis. Its incidence was significantly higher in males (P<0.001) and in patients with a history of high/moderate alcohol intake (P<0.02); these findings are reminiscent of the presence of a similar relationship between these factors and duodenal ulcers and support the suggestion that duodenitis and duodenal ulcers probably represent different parts of a single disease spectrum. The presence of both types of metaplasia in 9% of the patients suggest that factors other than gastric acidity may influence the development of metaplasia.
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References
Wilhelm DL: Inflammation and healing.In Pathology, 7th edition, Vol 1. WAD Anderson, JM Kissane (eds). St. Louis, CV Mosby, 1977, p 81
Morson BC: Intestinal metaplasia of the gastric mucosa. Br J Cancer 9:365–376, 1955
Rubin W: Intestine in the stomach. Transformation of the gastric mucosa into an absorptive tissue. Gastroenterology 54:116–118, 1968
Matsukura N, Kawachi T, Sasajima K, Sano T, Sugimura T: Induction of intestinal metaplasia in the stomachs of rats byN-methyl-N-nitro-N-nitrosoguanidine. J Natl Cancer Inst 61:141–144, 1978
Watanabe H: Experimentally induced intestinal metaplasia in Wistar rats by x-ray irradiation. Gastroenterology 75:796–799, 1978
Watanabe H, Fujii I, Terada Y: Induction of intestinal metaplasia in the rat gastric mucosa by local x-irradiation. Pathol Res Pract 170:104–114, 1980
Samloff IM, Secrist DM, Passaro EP Jr: A study of the relationship between serum group I pepsinogen levels and gastric acid secretion. Gastroenterology 69:1196–1200, 1975
Stemmermann GN, Ishidate T, Samloff IM, Masuda H, Walsh JH, Nomura A, Yamakawa H, Glober G: Intestinal metaplasia of the stomach in Hawaii and Japan. A study of its relation to serum pepsinogen I, gastrin, and parietal cell antibodies. Am J Dig Dis 23:815–820, 1978
Shousha S, Spiller RC, Parkins RA: The endoscopically abnormal duodenum in patients with dyspepsia: biopsy findings in 60 cases. Histopathology 7:23–34, 1983
James AH: Gastric epithelium in the duodenum. Gut 5:285–294, 1964
Parrish JA, Rawlins DC: Intestinal mucosa in the Zollinger-Ellison syndrome. Gut 6:286–289, 1965
Rhodes J, Evans KT, Lawrie FH, Forrest APM: Coarse mucosal folds in the duodenum. Q J Med 37:151–169, 1968
Gear EV, Dobbins WO: The histologic spectrum of proximal duodenal biopsy in adult males. Am J Med Sci 257:90–99, 1969
Patrick WJA, Denham D, Forrest APM: Mucous change in the human duodenum: A light and electron microscopic study and correlation with disease and gastric acid secretion. Gut 15:767–776, 1974
Rhodes J: Experimental production of gastric epithelium in the duodenum. Gut 5:454–458, 1964
Lessells AM, Martin DF: Heterotopic gastric mucosa in the duodenum. J Clin Pathol 35:591–595, 1982
Spiller RC, Shousha S, Barrison IG: Heterotopic gastric tissue in the duodenum: A report of eight cases. Dig Dis Sci 27:880–883, 1982
Nomura A, Yamakaw H, Ishidate T, Kamiyama S, Masuda H, Stemmermann GN, Heilbrun LK, Hankin JH: Intestinal metaplasia in Japan: Association with diet. J Natl Cancer Inst 68:401–405, 1982
Jass JR, Filipe MI: A variant of intestinal metaplasia associated with gastric carcinoma: A histochemical study. Histopathology 3:191–199, 1979
Matsukura N, Suzuki K, Kawachi T, Aoyagi M, Sugimura T, Kitaoka H, Numajiri H, Shirota A, Itabachi M, Hirota T: Distribution of marker enzymes and mucin in intestinal metaplasia in human stomach and relation of complete and incomplete types of intestinal metaplasia to minute gastric carcinoma. J Natl Cancer Inst 65:231–240, 1980
Sipponen P, Seppälä K, Varis K, Hjelt L, Ihamäki, Kekki M, Siurala M: Intestinal metaplasia with colonic-type sulphomucins in the gastric mucosa; its association with gastric carcinoma. Acta Pathol Microbiol Scand Sect A 88:217–224, 1980
Lev R, Thomas E, Parl FF, Pichumoni CS: Pathological and histomorphometric study of the effects of alcohol on the human duodenum. Digestion 20:207–213, 1980
Whitehead R, Roca M, Meikle DD, Skinner R, Truelove SC: The histological classification of duodenitis in fibreoptic biopsy specimens. Digestion 13:129–136, 1975
Sturdevant RAL, Walsh JH: Duodenal ulcer.In Gastrointestinal disease. Patholophysiology, Diagnosis, Management, 2nd edition, Vol 1. MH Sleisenger, JS Fordtran (eds). Philadelphia, WB Saunders, 1978, pp 840–860
Thomson WO, Joffe SN, Robertson AG, Lee FD, Imrie CW, Blumgart LH: Is duodenitis a dyspeptic myth? Lancet 1:1197–1198, 1977
Pinbello W, Vantini I, Scuro LA, Novelli P, Benini L, Brocco G, Cavallini G: Gastric secretion, gastroduodenal histological changes, and serum gastrin in chronic alcoholic pancreatitis. Am J Gastroenterol 77:105–110, 1982
Schulze S, Thorsgaard Pedersen N, Jørgensen MJ, Møllmann K-M, Rune SJ: Association between duodenal bulb ulceration and reduced pancreatic function. Gut 24:781–783, 1983
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Dr. S. Khan is supported by the Cancer Research Campaign.
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Shousha, S., Barrison, I.G., El-Sayeed, W. et al. A study of incidence and relationship of intestinal metaplasia of gastric antrum and gastric metaplasia of duodenum in patients with nonulcer dyspepsia. Digest Dis Sci 29, 311–316 (1984). https://doi.org/10.1007/BF01318515
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DOI: https://doi.org/10.1007/BF01318515