CHRONIC ATROPHIC FUNDIC GASTRITIS DIAGNOSED BY A MODIFIED CONGO RED TEST

Background and Study Aims: Chronic atrophic fundic gastritis (CAFG) is associated with several diseases, such as gastric cancer, gastric ulc er, pernicious anemia, and bacterial overgrowth, In spite of recent te chnical improvements, the gastroscopic diagnosis of CAFG remains uncer tain, Congo red chromogastroscopy is capable of visualizing acid-produ cing normal fundic mucosa, but has hitherto not been suitable for rout ine use, The aim of our study was to establish a reliable endoscopic t echnique with which to diagnose CAFG. Patients and Methods: This prosp ective study comprises 124 consecutive patients (71 women, 53 min) wit h a mean age of 65 years (range 36-92), Macroscopic evaluation of the gastric fundic mucosa in routine endoscopy using video techniques was compared with evaluation by means of a modified endoscopic Congo red t est (MCRT), In routine gastroscopy, CAFG was recognized by the thin, f riable mucosa, with a marked visible vascular pattern and fold atrophy With MCRT, the diagnosis of CAFG was made within five minutes' observ ation when no red-to-blue color shift in the fundic mucosa could be in duced by 0.2 mu g/kg intravenous pentagastrin. The results were then c ompared with the histological examination of biopsies from the fundic mucosa, Results: CAFG was confirmed by histology in 40 of 124 cases, T he diagnostic sensitivity of MCRT was 1.0 (40/40), with a positive pre dictive value of 0.90, whereas the values for macroscopic gastroscopic evaluation were 0.25 (10/40) and 0.50, respectively, Conclusions: We conclude that MCRT is a sensitive, fast, and cost-effective method of identifying patients with CAFG, and well suited for use in routine gas troscopy.