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Volume 13 Issue 3 (March) 2024

Original Articles

Histomorphological evaluation of Esophagus in Cases Of Gastroesophageal reflux Disease and its association with Gastric H. Pylori Infection
Dr. Radhika Arumugam Rangaraj, Dr. Premalatha Varadarajan, Dr. Vanitha Madaswamy

BACKGROUND: Helicobacter pylori is a gram-negative, microaerophilic bacterium that inhabits various areas of the stomach and duodenum. Recently, it has been observed that gastric colonization with H.pylori may also have beneficial effects for the human host. In this respect, the interest is in particular going to the potential preventive effect of H.pylori colonization on the development of gastro-esophageal reflux disease (GERD) and its complications. This interesting note made us think to evaluate the various histomorphological changes seen in esophagus in cases of GERD and to correlate the findings with the status of gastric H pylori colonization in those cases. METHODOLOGY: In our study 150 cases of patients presenting with symptoms of GERD were included. The patients were evaluated clinically and subjected to upper Gastrointestinal (GI) endoscopy the findings in the upper gastrointestinal (UG) endoscopy were recorded and biopsy were taken from the esophageal lesions. Subsequent gastric antral biopsies were also done in these cases. The histopathological changes of esophagus were recorded. The findings were correlated with the H. Pylori status of the gastric antral biopsies. RESULTS: In our study population of 150 cases of GERD esophageal biopsy was done in all 150 cases and gastric antral biopsy was done in 138 patients. In our study population 88 patients had chronic reflux esophagitis, 46 had Barrett’s esophagus, vascular ecstasia was seen in 4 and malignancy was present in 12 cases. Among 12 malignant cases adenocarcinoma was present in 3 patients and squamous cell carcinoma was present in 9 patients. Among total 138 gastric antral biopsies we did H.Pylori positivity was seen in 50 (32.6%) of patients. CONCLUSION: In our study, 39% of cases with chronic esophagitis had H.pylori positivity, 34% of cases with Barrett's oesophagus had H.Pylori positivity and none of the malignancy cases had H.pylori positivity. So it is observed that patients with H.pylori positivity has low incidence of Barrett’s oesophagus and adenocarcinoma. Henceforth whether the presence of H.Pylori infection in GERD patient’s decrease the incidence of malignancy needs to be further studied.

 
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