Gastric cardia inflammation and intestinal metaplasia: Associations with reflux esophagitis and Helicobacter pylori

Gastric cardia inflammation and intestinal metaplasia are the subjects of r ecent investigation. Some authors have found associations with gastroesopha geal reflux disease, whereas others have identified relationships with Heli cobacter pylori (HP), We studied 150 consecutive patients who underwent upp er endoscopy, had normal gastroesophageal anatomy, and had biopsies of the antrum, cardia, and lower esophagus, to evaluate relationships between refl ux esophagitis, cardia inflammation, intestinal metaplasia, and HP gastriti s, Forty-two patients had HP infection. Cardia inflammation was significant ly related to esophageal squamous inflammation in the non-HP-infected patie nt group and to antral inflammation and cardia HP infection in the HP-infec ted patient group, The differences between the patient groups was most appa rent in the patients with moderate or marked inflammation, Twenty-seven per cent of patients had cardia intestinal metaplasia that was related to cardi a inflammation, Cardia inflammation and intestinal metaplasia probably have multiple causes. Pathologists should refrain from applying the term Barret t's esophagus for biopsies procured from the cardia that show intestinal me taplasia in patients with a normal squamocolumnar junction.