Prevalence of cardial or fundic mucosa and Helicobacter pylori infection in patients with chronic gastroesophageal reflux

Background: The mucosa distal to the endoscopic mucosal change zone can hav e easily diagnosed early alterations, in patients with chronic gastroesopha geal reflux. Aim: To determine the type of mucosa existent ill the rone dis tal to the squamous-columnar junction in patients with chronic gastroesopha geal reflux without intestinal metaplasia. Patients and methods: One hundre d thirty four controls and 208 patients with chronic gastroesophageal reflu x lasting two years were studied. Forty three of these patients had a norma l endoscopy, 54 had an erosive esophagitis and 111 had a short columnar epi thelium covering the distal esophagus, without intestinal metaplasia. In al l subjects, four biopsies were obtained from a zone distal to the squamous- columnar junction and two from the distal gastric antrum. Results: In 59% o f control subjects fundic mucosa was present in the zone distal to the squa mous-columnar junction. Cardial mucosa was present in the rest. In patients with chronic gastroesophageal reflux, cardial mucosa was predominant. Heli cobacter pylorii infection decreased along with increasing extension of car dial mucosa covering the distal esophagus. Conclusions: In patients with ch ronic gastroesophageal reflux there is a metaplasia of fundic mucosa toward s cardial mucosa. On the other hand, Helicobacter pylorii infection decreas es gradually.