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[Reactive gastritis in patients with diabetics with dyspeptic symptoms]
M Małecki1, A I Bień, D Galicka-Latała
1Z Katedry i Kliniki Chorób Metabolicznych Collegium Medicum, Uniwersytetu Jagiellońskiego w Krakowie.
Unlabelled:
There is very few data on the prevalence of reactive gastritis (RG) in diabetes mellitus (DM). The typical histological findings in RG are foveolar hyperplasia, oedema with apparent diminution in glands, telangiectasia of lamina propria, a paucity of inflammatory cells. RG has been connected so far with a long term use of non-steroidal anti-inflammatory drugs (NSAIDs) or bile reflux, which is particularly frequent after cholecystectomy. RG is regarded as less frequently associated with the Helicobacter pylori (Hp) infection. The aim of the study was to define: 1. The prevalence of RG in diabetics with dyspeptic symptoms as compared with the non-diabetic group. 2. The prevalence of Hp infection in RG as compared with chronic active gastritis (CAG) in DM. 3. The association of these types of gastritis with autonomic neuropathy (AN).
Study Design:
Gastroscopy was performed in 152 patients with symptoms related to upper alimentary tract disorders-52 with DM (13 with IDDM and 39 with NIDDM) and 100 without DM. The presence of RG, CAG and Hp infection was analysed in 3 biopsies. AN was evaluated in 35 diabetics in 4 cardiovascular tests using ProSciCard.
Results:
RG was significantly more frequent in DM than in control group (10/52, 19.2% vs. 3/100, 3%, respectively, p < 0.01). This difference was preserved after excluding all patients with NSAIDs use or being after cholecystectomy (8/36, 22.2% vs. 2/81, 2.5%, respectively, p < 0.001). Hp infection in diabetics with RG was significantly lower than diabetics with CAG (2/10, 20% vs. 16/23, 69.5%, respectively, p < 0.05). AN was more frequent in diabetics with RG than with CAG (7/10, 70% vs. 6/15, 40%, respectively, p < 0.001). Hp infection in diabetics with RG was significantly lower than diabetics with CAG (2/10, 20% vs. 16/23, 69.5%, respectively, p < 0.05). AN was more frequent in diabetics with RG than with CAG (7/10, 70% vs. 6/15, 40%, respectively), the difference was not significant with this sample size.
Conclusions:
1. RG seems to be more frequent in DM than in general population. 2. Hp infection is less frequent in RG than in CAG in DM. 3. The higher prevalence of RG in DM may result from impaired motility and reflux of bile caused by AN.