Objective:

We investigated endoscopic and pathological changes in the gastric mucosa and the frequency of Helicobacter pylori (Hp) infection in patients undergoing gastroenterostomy surgery.

Materials and Methods:

Patients who were admitted to our hospital between November 2009 and April 2010 and who had previously undergone gastroenterostomy surgery for any reason were included in the study. The control group consisted of patients without gastroenterostomy who underwent routine endoscopy.

Results:

Hp was positive in 10 of 70 patients with gastroenterostomy (14.3%) and in 30 of 50 patients (60%) in the control group. The difference between the two groups was statistically significant (p<0.001). Intestinal metaplasia was detected in 22 of 70 patients (31.4%) and in 8 of 50 patients (16%) in the gastroenterostmy and control groups, respectively (p=0.054). Atrophic gastritis was detected in 42 of 70 patients (60%) and in 15 of 50 patients (30%). The difference was statistically significant (p<0.01). Dysplasia and adenocarcinoma were detected in 4 (5.5%) patients (dysplasia in 1 patient, adenocarcinoma in 3 patients) in the gastroenterostomy group, but not in the control group (p<0.02).

Conclusion:

This study showed that the frequency of enterogastric reflux increased in patients who underwent gastroenterostomy and correspondingly decreased Hp’s frequency. The incidence of atrophic gastritis and dysplasia from precancerous gastric lesions is significantly higher in patients who undergo gastroenterostomy. In light of these results, because enterogastric reflux and Hp have a synergistic damage effect on the gastric mucosa, we recommend that patients with gastroenterostomy should be tested for Hp, and if positive, they should be eradicated, and biopsies should be taken from the distal remnant gastric mucosa close to the stoma line.

Keywords: Aging, cell biology, geriatric care management, geriatric palliative care, geriatrics