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Carditis: all Helicobacter pylori or is there a role for gastro-oesophageal reflux?

D McNamara1, M Buckley, P Crotty

  • 1Adelaide and Meath Hospital, Trinity College, Dublin, Ireland. dimac1@indigo.ie

Scandinavian Journal of Gastroenterology
|August 23, 2002
PubMed

Insights

Helicobacter pylori infection is strongly linked to carditis and cardia intestinal metaplasia (CIM) in dyspeptic individuals. Gastro-oesophageal reflux disease showed no association with these conditions.

Area of Science:

  • Gastroenterology
  • Pathology

Background:

  • Epidemiological studies show a threefold increase in lower oesophageal and cardia adenocarcinoma.
  • Conflicting data exists on the roles of gastro-oesophageal reflux disease (GERD) and Helicobacter pylori (H. pylori) in carditis and cardia intestinal metaplasia (CIM).
  • Evidence suggests GERD and H. pylori are inversely related, complicating etiological understanding.

Purpose of the Study:

  • To determine the prevalence of carditis and CIM in dyspeptic subjects.
  • To investigate the association of carditis and CIM with H. pylori infection.
  • To examine the association of carditis and CIM with GERD.

Main Methods:

  • Histological samples of the gastric cardia were obtained from 276 dyspeptic subjects.
  • H. pylori status was determined through histological, microbiological, and rapid urease testing.
  • GERD was diagnosed based on histological evidence and/or erosive oesophagitis.

Main Results:

  • Carditis was present in 59% (163/276) and CIM in 13% (36/276) of subjects.
  • H. pylori infection was found in 23% (64/276) and GERD in 54% (150/276).
  • H. pylori infection showed a strong association with carditis (P<0.001) and CIM (P<0.01). Older age and male gender were also associated with carditis and CIM. GERD was not associated with either condition.

Conclusions:

  • Carditis and CIM are frequent findings in dyspeptic patients.
  • H. pylori infection is significantly associated with both carditis and CIM.
  • No association was found between gastro-oesophageal reflux disease and carditis or CIM.
Abstract

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