Euroasian journal of hepato-gastroenterology

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VOLUME 6 , ISSUE 2 ( July-December, 2016 ) > List of Articles

ORIGINAL ARTICLE

Histopathological Assessment of Dyspepsia in the Absence of Endoscopic Mucosal Lesions

Hosam M Dawod, Mahmoud W Emara

Citation Information : M Dawod H, W Emara M. Histopathological Assessment of Dyspepsia in the Absence of Endoscopic Mucosal Lesions. Euroasian J Hepatogastroenterol 2016; 6 (2):97-102.

DOI: 10.5005/jp-journals-10018-1178

License: CC BY-NC 4.0

Published Online: 01-01-2010

Copyright Statement:  Copyright © 2016; The Author(s).


Abstract

Introduction: Dyspepsia is a common symptom with an extensive differential diagnosis. Endoscopy alone may miss serious mucosal lesions in about 15 to 30% of cases. The aim was to determine histopathological features of gastric and duodenal mucosal biopsies in patients with dyspepsia and normal looking upper gastrointestinal (GI) endoscopy. Materials and methods: One hundred and five adult patients presenting with dyspepsia with no endoscopic mucosal lesions in the upper GI tract were included. Gastric biopsy specimens according to Sydney–Houston system for grading gastritis and biopsy from duodenum were taken. The histopathological features were graded according to the Sydney–Houston system classification for grading gastritis. Results: The histological lesions were found in 65.7% (69 out of 105 endoscopy free dyspeptic patients). Chronic inflammation was the commonest finding. Neutrophilic activity, glandular atrophy, and mild degree of intestinal metaplasia were present in 27, 45, and 6 patients (22.8, 42.8, and 5.7% respectively). Helicobacter pylori was present in 54 patients with histopathological lesions and in 6 patients without histopathological lesions, and the difference was significant (p = 0.045). Conclusion: The endoscopic diagnosis of dyspepsia correlated poorly with histopathological findings. The histopathological examination allowed detection and grading of gastric pathology in dyspepsia with normal endoscopy and the commonest finding was the moderate chronic gastritis.


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  1. Conoroy RT, Siddiqi. B. Dyspepsia. Prim Care 2007 Mar;34(1): 99-108
  2. American Gastroenterological Association technical review on the evaluation of dyspepsia. Gastroenterology 2005 Nov;129(5):1756-1780. Hosam M Dawod, Mahmoud W Emara 102 3. Drossman DA. The functional gastrointestinal disorders and the Rome III process. Gastroenterology 2006 Apr;130(5): 1377-1390
  3. Endoscopic evaluation of patients with dyspepsia: results from the national endoscopic data repository. Gastroenterology 2004 Oct;127(4):106-775
  4. Dyspepsia. Ann Intern Med 2001 May;134(9 Pt 2):815
  5. Helicobacter pylori in developing countries. J Dig Dis 2011 Oct;12(5):319-326
  6. Secular trends in Helicobacter pylori seroprevalence in adults in the United States: evidence for sustained race/ethnic disparities. Am J Epidemiol 2012; 175(1):54-59
  7. Complications of upper GI endoscopy. Gastrointest Endosc 2002;55:784-93
  8. Relationship of gastroscopic features to histological findings in gastritis and Helicobacter pylori infection in a general population sample. Endoscopy 2003 Nov;35(11):946-950
  9. Gastroscopy is incomplete without biopsy: clinical relevance of distinguishing gastropathy from gastritis. Gastroenterology 1995 Mar;108(3):917-924
  10. Endoscopic and histopathological findings of the upper gastrointestinal tract in patients with functional and organic dyspepsia. Przegl Lek 2014;71(4):204-209
  11. Classification and grading of gastritis. Am J Surg Pathol 1996 Oct;20(10):1161-1181
  12. Endoscopic mucosal tissue sampling. Gastrointest Endosc 2013 Aug;78(2):216-224
  13. Atrophic gastritis: pathology and endoscopy in the reversibility assessment. Gut 2003 Sep;52(9):1387-1388
  14. Functional gastroduodenal disorders. Gastroenterology 2006 Apr;130(5):1466-1479
  15. Symptom-based outcome measures for dyspepsia and GERD trials: a systematic review. Am J Gastroenterol 2005 Feb;100(2):442-452
  16. Gastric mucosa in nonulcer dyspepsia: a histopathological study of Nigerian patients. I J Gastroenterol 2007;5(2)
  17. Could gastric histology be a useful marker for making decision on Helicobacter pylori eradication therapy in patients with dyspepsia? Arq Gastroenterol 2009 Jul-Sep;46(3):209-213
  18. Histopathological analysis of chronic gastritis and correlation of pathological features with each other and with endoscopic findings. Pol J Pathol 2012;3:172-178
  19. Endoscopic features of Helicobacter pylori induced gastritis. Saudi J Gastroenterol 1999 Jan;5(1):9-14
  20. Improvement of gastric inflammation and resolution of epithelial damage one year after eradication of Helicobacter pylori. J Clin Pathol 1995 Mar;48(3):250-256
  21. Correlation between endoscopic features of gastric antrum, histology and Helicobacter pylori infection in adults. Ital J Gastroenterol Hepatol 1999 Jun-Jul;31(5):359-365
  22. Role of Helicobacter pylori in functional dyspepsia. Indian J Surg 2004;66:341-346
  23. Clinical profile in H. pylori positive patients in Jammu. JK Sci 2006 Jul-Sep;8(3):148-150
  24. Chronic gastritis. Scand J Gastroenterol 2015 Jun;50(6):657-667
  25. Prevalence of H. pylori associated “high risk gastritis” for development of gastric cancer in patients with normal endoscopic findings. World J Gastroenterol 2006 Sep;12(34):5509-5512
  26. The frequency and type of histological gastric changes in patients with functional dyspepsia. 22nd United European Gastroenterology Week; 2014 Oct 18-22; Vienna, Australia
  27. American Gastroenterological Association institute technical review on the role of upper gastrointestinal biopsy to evaluate dyspepsia in the adult patient in the absence of visible mucosal lesions. Gastroenterology 2015 Oct;149(4):1088-1118.
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