Interest of endoscopic biopsy in the management of gastritis: about 250 consecutive cases

Background The practical role of gastric biopsy in the management of gastritis is controversial. Aim To estimate the yield of endoscopic biopsies in the clinical, endoscopic and pathologic approach of gastritis. Material and methods: Prospective study of 250 consecutive patients who underwent an upper G.I. endoscopy between July 1996 and January 1997, for upper G I symptoms, miscellaneous manifestations requiring an upper G.I. endoscopy or presenting a gastritis on EGD performed for other indications. Every patient had 6 biopsies: 2 in the antrum, 2 in the corpus, and 2 in an intermediate zone. Results After defining the abnormal elemental endoscopic and pathologic patterns, gastric mucosa was endoscopically normal in 57 cases [22.8%] and abnormal in the remaining of the 250 cases [77.2%]. The pathologic findings were normal in 69 cases [27.6%] and abnormal in the remaining 181 cases of 250. H pylori was found in 126 cases [50.4%], 10 cases of which [7.9%] had normal pathology. There was no significant correlation between clinical symptoms, endoscopy and pathology. There was a correlation between endoscopic abnormalities and tobacco use [P = 0.0073], NSAIDs use [P 0,0001] and the presence of H. pylori [P < 0,0001]. There was also a correlation between pathologic findings, tobacco use [P = 0.0015], NSAIDs use [P = 0.0022] and the presence of HP [P < 0.0001] On the other hand, there was a correlation between the presence of an inflammatory infiltrate in H. pylori gastritis [P 0.0007] and its absence in NSAIDs use [P = 0.0003]. The correlation between endoscopy and pathology existed only for certains patterns: erosion and ulcerations [P = 0.0002], purpuric [P = 0.033], congestion [P < 0.0001] and mosaic [0.0095]. Conclusion: Gastric biopsy brings no important practical supplement to endoscopic examination except in revealing the presence of H. pylori. It adds nothing to endoscopy in helping explain the clinical symptoms. But it is obvious that it may reveal some serious pre-malignant dysplasia or malignant gastric lesions [maltoma, linitis plastica]. This did not occur during our study

La famotidine dans le traitement de l'ulcere gastrique

In order to evaluate the efficacy and tolerance of Famotidine in the treatment of gastric ulcer, in Lebanese patients, we conducted a prospective open study in twenty one patients with benign gastric ulcer. A clinical, endoscopic and biological evaluation was done before, at 4 weeks and if necessary at 8 weeks after the start of 40 mg of Famotidine per day. All patients were carefully monitored at regular intervals for adverse drug reactions by clinical and biological examinations. The healing rate at 4 and 8 weeks was 75% and 91% respectively. The treatment was well tolerated and no modifications in laboratory tests were observed. Famotidine therefore proved effective in the treatment of gastric ulcer and was well tolerated on a short term basis