Effect of proton pump inhibitor therapy on inflammatory changes in the gastric cardia (carditis)

Shailender Singh, Ajay Bansal, Srinivas Puli, Sachin Wani, Sharad Mathur, Amit Rastogi, Prateek Sharma

Research output: Contribution to journalArticle

3 Scopus citations

Abstract

The etiology of inflammation of the gastric cardia (carditis) is controversial, and gastroesophageal reflux disease (GERD) and H. pylori infection have been proposed as etiological factors. This study aimed to investigate the effect of acid suppression on histological changes in the gastric cardia. Gastric cardia biopsies of reflux patients were evaluated at baseline and after proton pump inhibitor (PPI) therapy. The updated Sydney classification was used to score the biopsies, and carditis scores (pre- and post-PPI therapy) were compared. A total of 31 patients were included, of which 5 patients were excluded, as cardiac mucosa was not documented in either pre- or post-PPI biopsies. The mean duration of PPI therapy was 30 months (SE, 3.04 months). There was no significant change in carditis scores post-PPI therapy. The mean mononuclear and neutrophil scores were 1.23 and 0.35 pre-PPI therapy and 1.73 and 0.62 post-PPI therapy, respectively. No change in mean intestinal metaplasia and atrophy scores was identified. In conclusion, acid suppressive therapy with PPI did not lead to a significant reduction in carditis scores. These results suggest that GERD probably does not play a major role in the pathogenesis of inflammation in the gastric cardia.

Original languageEnglish (US)
Pages (from-to)2178-2182
Number of pages5
JournalDigestive Diseases and Sciences
Volume52
Issue number9
DOIs
StatePublished - Sep 2007

Keywords

  • Carditis
  • Gastric cardia
  • Inflammation
  • Proton pump inhibitors

ASJC Scopus subject areas

  • Physiology
  • Gastroenterology

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