Clinical Gastroenterology Vol.19 No.5(2)

Theme H.pylori Negative Upper Gastroenterological Diseases; Increasing of Their Incidence in the 21st Century
Title Helicobacter pylori Negative Atrophic Gastritis and Intestinal Metaplasia
Publish Date 2004/05
Author Hiroki Imazu Department of Surgery, Fujita Health University School of Medicine
Author Ichiro Uyama Department of Surgery, Fujita Health University School of Medicine
Author Yoshiyuki Komori Department of Surgery, Fujita Health University School of Medicine
Author Yoichi Sakurai Department of Surgery, Fujita Health University School of Medicine
Author Masahiro Ochiai Department of Surgery, Fujita Health University School of Medicine
[ Summary ] It is well known that atrophic changes and intestinal metaplasia of the gastric mucosa were caused more often by Helicobacter pylori (H.pylori) infection rather than aging, and negative cases are very rare. It has been reported that atrophic changes, without H.pylori infection, are seen only in 4 to 18% of cases and intestinal metaplasia without H.pylori infection was also observed in 2 to 6.2% of cases. In these cases, histological atrophy was milder in comparison with positive cases. Some of the factors (environmental, habitual, type A gastritis, complications from systemic diseases, e.g. inflammatory bowel disease, liver cirrhosis, chronic renal failure, etc., including post gasterectomy states) have been suggested as causes of H.pylori negative gastritis. Especially, patients with type A gastritis and remnant gastritis were at high risk for developing gastric carcinoma. Acceleration of the cell cycle and gene mutations of the remnant epithelium at the anastomotic site, caused by regurgitation of duodenal juice, were reported.
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