The specificity of endoscopic criteria in diagnosis Of biliary reflux gastritis

Abstract

Bile reflux gastritis can be triggered by an excess of bile in the duodenum, the absence of a pylorus as a barrier to retrograde flow, and/or decreased stomach and duodenum retrograde peristalsis. This can occur as a result of gastric or biliary surgery or as biliary reflux disease. The purpose of this research was to assess the specificity of endoscopic criteria in diagnosis of biliary gastritis by comparing the endoscopic findings with histopathological examination. Patients and methods: In this prospective research, cases with upper gastrointestinal symptoms were subjected for esophago-gastro-duodenoscopy. One hundred and thirteen patients with intragastric bile were involved in the research. All cases were subjected for endoscopic examination for biliary reflux gastritis and histopathological examination. Results: In this prospective study, 113 individuals were involved in this research divided into two groups, biliary reflux gastritis (BRG) (62 patients) and non-biliary reflux gastritis (NBRG) (51 patients). The Endoscopic findings of the patients in BRG group showed that all patients had intragastric bile and most of the patients had erythema (83.9%) followed by erosions (54.8%). Histological findings in BRG group showed that most patients had foveolar hyperplasia (83.9%) followed by chronic active inflammation (75.8%) and congestion (64.5%). The positive predictive value of endoscopic diagnosis of biliary gastritis was 54.86%. Conclusion: In biliary reflux gastritis the endoscopic findings are not specific but can help in diagnosis, histopathological features can characterize biliary reflux gastritis from non-biliary reflux gastritis.