An insight into post-gastrectomy "alkaline reflux gastritis"

One hundred and ten partially-gastrectomized patients were studied in order to assess prevalence of symptoms, entero-gastric reflux, endoscopic erythematous changes and histological gastritis and to explore some aspects of the pathogenesis of gastritis syndrome. Prevalence of symptoms (37.2% of the patients) was lower than prevalence of reflux (86.9% and 72.9% of patients with fasting bile reflux or scintigraphic assessment, respectively) endoscopic hyperaemia (72.7% of patients) and remnant chronic gastritis (88.3% of patients). Histological appearance in the perianastomotic area was mostly identifiable as hyperplastic-regenerative. While histological findings, gastric pH, bacteria and nitrite concentration and patients' age were reciprocally correlated, symptoms, endoscopic changes, remnant chronic gastritis and gastric environmental changes were not more severe in patients with more abundant enterogastric reflux. Therefore, as far as the methods for reflux assessment used in the present study are concerned, postgastrectomy findings (symptoms, extent of erythematous changes, severity of remnant chronic gastritis) are not related to reflux. These results suggest that the term "alkaline reflux gastritis syndrome", at this stage of knowledge, should be used with caution.