ABSTRACT
Collagenous gastritis is hardly ever found in children and adults. Based on the extent of collagenous changes in the bowel, various symptoms may develop including iron deficiency, anemia, and abdominal pain in most of the patients.
We present a 30-year-old man with persistent abdominal pain and anemia due to collagenous gastritis
ABSTRACT
Background: Reflux disease is a common gastrointestinal problem. The association between reflux disease and gastritis pattern is controversial
Aim: To determine the association between reflux disease and gastritis pattern in patients with Helicobacter pylori [H. pylori] infection
Methods: 470 patients with dyspepsia and reflux disease were enrolled in this study. The inclusion criteria were willing to participate in the study, age over 40 years, and having the criteria of ROME III for at least 3 months. Patients with history of H. pylori eradication therapy during the 3 months before the study, a history of gastric surgery, and gastric cancer were excluded. All of the participants underwent upper endoscopy and two biopsy samples were taken from antrum, body, and fundal areas
Results: H. pylori infection rate was 367 [78.1%] with mean age of 59.8 +/- 11.4 years. Of them 131 patients [35.7%] were male. Reflux disease was detected in 273 [74.4%] patients. 216 [58.9%] and 102 [27.8%] patients had non-erosive reflux disease [NERD] and gastroesophageal reflux disease [GERD], respectively. Corpus predominant and antral predominant gastritis were seen in 72 [19.6%] and 129 [35.2%] patients, respectively. Antral gastritis was significantly associated with GERD [p<0.01]. In regression analysis, antral predominant gastritis had a significant association with GERD [OR=1.92; 95%CI: 1.22-3.12]. The same result was observed in mild to moderate antral and greater curvature gastritis [OR= 1.26; 95%CI: 0.25-6.40 and OR= 3.0; 95%CI: 0.63-14.17, respectively]
Conclusion: According to these finding, we could suggest that the pattern of gastritis could be associated with reflux disease and GERD
ABSTRACT
Recent guidelines have proposed that there is a correlation between tissue transglutaminase [tTG] antibody titers and degrees of duodenal biopsy, and that duodenal biopsy can be omitted in some patients with high levels of tTG antibody. Using data of registered patients in a gastrointestinal clinic we aimed to assess the correlation between tissue transglutaminase antibody with duodenal histologic Marsh grading in Iranian patients with celiac disease. We retrospectively reviewed hospital files of registered patients in the gastrointestinal clinic of Firoozgar Hospital, Tehran, Iran. Demographic, laboratory, and histology data of those who had tTG titer and pathology reports of duodenal biopsy based on the modified Marsh classification were extracted and used for the study. 159 patients with available tTG titer and pathology reports were enrolled in our study. Mean +/- SD of the patients was 35.6 +/- 15.2 and 100 [62.9%] of them were women. 133 out of 153 patients had villous atrophy [Marsh IIIa-IIIc]. Anemia was the most common sign and bloating, abdominal pain, and diarrhea were the first three common symptoms in these patients. Mean tTG titers was significantly higher in patients graded as Marsh III [p for trend=0.003]. Our results showed that tTG titer more than 9 folds higher than the kit's cut-off value was about 97.2% sensitive for Marsh II and more duodenal damage. There was a correlation between tTG titers and degrees of duodenal damage in patients with celiac disease. Duodenal biopsy is not always necessary for diagnosing celiac disease and when tTG level is more than 9 folds higher than the manufacture's recommended cut-off value it can be avoided. Meanwhile in case of high clinical suspicion, low tTG levels do not exclude diagnosis of celiac disease and further investigations including small intestinal biopsy should be considered