Observations on gastric histology, endoscopy appearance and Helicobacter pylori after corrective surgery for bile...

This study was designed to look for the presence of Campylobacter pylori in patients who had Roux-en-Y procedure to control symptoms of severe alkaline reflux gastritis (ARG) and to correlate findings with endoscopy and histology. Twenty five patients, who had been operated on for ARG during the last 15 years, were recruited into this study (mean age: 53 years). Surgical procedures were performed by a single surgeon (K.B.). Clinical symptoms of ARG improved after corrective surgery in all cases, but endoscopic pictures remained abnormal in 14 of 25 patients and histological gastritis was observed in all cases. Helicobacter pylori were detected in 8 patients using an urease test performed on gastric mucosa biopsies (CLO-Gistbrocades test). All 8 patients had their biliary diversion 10 or more years earlier, suggesting that H-pylori colonisation of the gastric mucosa develops only slowly once the bile reflux has been stopped. Longitudinal studies, looking for the presence of H-pylori in postoperative stomachs, may help in determining whether they have a role in the aethiology of the peptic ulcer and gastritis, or whether it really is only an innocent bystander.