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. 2022 Feb 23;12(3):572.
doi: 10.3390/diagnostics12030572.

Pyloric Incompetence Associated with Helicobactor pylori Infection and Correlated to the Severity of Atrophic Gastritis

Takuki Sakaguchi  1 , Takaaki Sugihara  1 , Ken Ohnita  2   3 , Daisuke Fukuda  2   4   5 , Tetsuro Honda  6 , Ryohei Ogihara  1 , Hiroki Kurumi  1 , Kazuo Yashima  1 , Hajime Isomoto  1   2
Affiliations

Pyloric Incompetence Associated with Helicobactor pylori Infection and Correlated to the Severity of Atrophic Gastritis

Takuki Sakaguchi et al. Diagnostics (Basel). .

Abstract

Duodenogastric reflux (DGR) causes bile reflux gastritis (BRG) and may develop into gastric cancer. DGR is classified as primary in non-operated stomachs or secondary to surgical intervention. Primary DGR and Helicobacter pylori (H. pylori) infection are reportedly related. However, the mechanism is not fully understood. This study aimed to elucidate the relationship between H. pylori infection and pyloric incompetence in a non-operated stomach. A total of 502 non-operated participants who underwent an upper intestinal endoscopy were prospectively enrolled. Endoscopic findings (EAC, endoscopic atrophy classification; nodular gastritis; xanthoma; fundic gland polyp; and incompetence of pylorus), sex, age, gastrin, pepsinogen (PG) I and PG II levels were evaluated. PG I/PG II ratio, anti-H. pylori-Ab positivity, and atrophic gastritis status were significantly different between the normal and incompetent pylori (p = 0.043, <0.001, and 0.001, respectively). Open-type atrophic gastritis was significantly higher in the incompetent pylori. Incompetence of the pylorus and EAC were moderately correlated (Cramer’s V = 0.25). Multivariate analysis revealed that the presence of anti-H. pylori-Ab was the only independent factor associated with the incompetence of the pylorus, with an adjusted odds ratio of 2.70 (95% CI: 1.47−4.94, p = 0.001). In conclusion, pyloric incompetence was associated with H. pylori infection and moderately correlated to the severity of atrophic gastritis in non-operated stomachs.

Keywords: Helicobacter pylori; atrophic gastritis; bile reflux gastritis; duodenogastric reflux; pylorus.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Essential endoscopic findings. (a) Endoscopic atrophic gastritis (Open type); (b) xanthoma; (c) nodular gastritis; (d) fundic gland polyp; (e) incompetent pylorus; (f) normal pylorus.
Figure 2
Figure 2
Endoscopic atrophic classification and competence of pylorus. The incidence of pyloric incompetence increased with the severity of atrophic gastritis. Particularly, the incidence of incompetent pylori was significantly higher in open-type atrophic gastritis (8.2% vs. 20.9%, p < 0.001).
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