Corpus gastritis is protective against reflux oesophagitis

Background-Gastric acid is important in the pathogenesis of reflux oesophag itis. Acid production by the gastric corpus is reduced in corpus gastritis. Aims-To determine whether corpus gastritis protects against reflux oesophag itis. Methods-Patients presenting for elective oesophagogastroduodenoscopy were s tudied. Two biopsy specimens were taken from the antrum, corpus, and cardia and stained with haematoxylin/eosin and Diff-Quick II stains. The presence and severity of gastritis were graded according to a modified updated Sydn ey classification. Results-Of 302 patients, 154 had endoscopic signs of reflux oesophagitis. T here was no difference between patients with and controls without oesophagi tis in the overall infection rates with Helicobacter pylori. Acute or chron ic corpus gastritis occurred less often in patients with than those without reflux oesophagitis. Compared with controls, corpus gastritis was less sev ere in patients with reflux oesophagitis. The presence of acute or chronic gastritis in the corpus was significantly correlated with either type of ga stritis in other areas of the stomach, In a multivariate logistic regressio n, age, sex, smoking status, and the presence of chronic corpus gastritis a ll exerted a significant influence on the presence of reflux oesophagitis. Chronic corpus gastritis was associated with a 54% reduced risk for reflux oesophagitis. Conclusions-While infection with H pylori alone may not affect the occurren ce of reflux oesophagitis, the development of chronic corpus gastritis seem s to be protective.