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The Egyptian Journal of Internal Medicine
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Primary bile reflux gastritis versus Helicobacter pylori gastritis: a comparative study

The Egyptian Journal of Internal Medicine volume 30, pages 23–27 (2018)Cite this article

Abstract

Background

Bile reflux gastritis (BRG) is a common disorder, with few data on its pathophysiology and clinical course, whereas Helicobacter pylori is the well-known, commonest cause of chronic gastritis.

Aim

The aim of this study was to compare between BRG and H. pylori-related gastritis, as regards demographic data, comorbid conditions, and pattern of upper gastrointestinal involvement.

Patients and methods

It included 130 patients with endoscopic features of gastritis, subdivided into three groups: group A with BRG (56 patients); group B with H. pylori gastritis (58 patients); group C with gastritis in the presence of both H. pylori and bile reflux (16 patients). Statistical analysis was made to compare between the three groups as regards demographic data, history, and examination findings including endoscopic findings.

Results

BRG is more common among younger age (21–30 years) and elderly patients (71–80 years), whereas H. pylori gastritis is more common in patients in the middle age group (31–60 years), the female/male ratio was 1.5 : 1 in patients with BRG, 1 : 1 in H. pylori gastritis. Nausea was the commonest symptom in patients with BRG (69.6%), whereas epigastric pain/discomfort was the commonest symptom (77.6%) in H. pylori gastritis. Diabetes was found to be more common in patients with H. pylori gastritis (29.3%) followed by BRG (26.8%), whereas obesity was more common in patients with BRG (76.8%) followed by H. pylori gastritis (65.5%). Endoscopy showed antral gastritis in cases with BRG (57.1%), pangastritis in H. pylori and mixed etiology gastritis (60.3 and 68.8%, respectively), reflux esophagitis in both BRG and H. pylori gastritis (41.1 and 44.8%, respectively), higher than mixed etiology gastritis (25%). Endoscopic Barrett’s mucosa was diagnosed in 10.7% of cases with BRG and 12.1% of cases with H. pylori gastritis. Duodenitis, duodenal erosions, or ulcerations were more common in cases with mixed etiology gastritis (62.5%), than in H. pylori gastritis (24.1%), followed by BRG (14.3%).

Conclusion

BRG is a common, underdiagnosed condition, with distinct clinical and endoscopic features from H. pylori gastritis.

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Authors and Affiliations

  1. Department of Internal Medicine, Taibah University, 35516, Medina, Kingdom of Saudi Arabia

    Enaase A. M. E. Barakat MD

  2. Department of Internal Medicine, Faculty of Medicine, Mansoura University, Mansoura, Kingdom of Saudi Arabia

    Neven F. Abbas

  3. Department of Internal Medicine, Al-Azhar University, Cairo, Egypt

    Nashwa Y. El-Kholi

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  1. Enaase A. M. E. Barakat MD
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  2. Neven F. Abbas
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Correspondence to Enaase A. M. E. Barakat MD.

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Barakat, E.A.M.E., Abbas, N.F. & El-Kholi, N.Y. Primary bile reflux gastritis versus Helicobacter pylori gastritis: a comparative study. Egypt J Intern Med 30, 23–27 (2018). https://doi.org/10.4103/ejim.ejim_42_17

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  • DOI: https://doi.org/10.4103/ejim.ejim_42_17

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