Research status and hotspots of autoimmune gastritis: A bibliometric analysis.

BACKGROUND: As an emerging potential risk factor for gastric cancer, autoimmune gastritis (AIG) has garnered increasing attention from researchers. AIM: To analyze the research overview and popular topics in the field of AIG using bibliometrics. METHODS: Relevant publications on AIG in the Web of Science Core Collection were collated, and data visualization and analysis of the number of publications, countries, institutions, journals, authors, keywords, and citations were performed using software such as VOSviewer, CiteSpace, and Scimago Graphic. RESULTS: In total, 316 relevant articles were included in the analysis. From 2015 to 2022, the number of publications increased annually. The countries, institutions, authors, and journals with the highest number of publications in this field were Italy, Monash University, Toh BH, and Internal Medicine. The main keywords used in this field of research were pathogenesis, Helicobacter pylori, autoantibody, parietal cell antibody, atrophic gastritis, classification, diagnosis, autoimmune disease, risk, cancer, gastric cancer, vitamin B12 deficiency, and pernicious anemia. The following directions may be popular for future research: (1) The role of Helicobacter pylori in the pathogenesis of AIG; (2) diagnostic criteria for AIG and reference values for serum antibodies; (3) comorbidity mechanisms between AIG and other autoimmune diseases; (4) specific risks of AIG complicating gastric and other cancers; and (5) the role of vitamin B12 supplementation in patients with early-stage AIG. CONCLUSION: This bibliometric analysis reported on popular topics and emerging trends in AIG, with diagnosis and prognosis being research hotspots in this field.

Pediatric Collagenous Gastritis: Clinical and Histologic Outcomes in a Large Pediatric Cohort.

OBJECTIVE: The aim of the study was to present the clinical characteristics, treatment, and outcomes of pediatric collagenous gastritis (CG). METHOD: This is a retrospective cohort study. Patients were identified via query of the institutional pathology database. Clinical data was obtained by review of medical records. RESULTS: Forty patients (57.5% female) were identified, mean age 11.3 ±â€Š3.7 years (2-16years). Isolated CG was present in 66.7%, coexisting collagenous duodenitis (CD) in 17.5%, collagenous colitis (CC) in 7.5%, and collagenous ileitis in 2.5%. Atopic comorbidities were found in 25%, autoimmune comorbidities in 12.5%. PRESENTING SYMPTOMS: Abdominal pain (77.5%), vomiting (65%), anemia (57.5%), nausea (55.5%), diarrhea (32.5%), anorexia (25.0%), weight loss (25%), gastrointestinal bleed (22.5%), poor growth (20%), poor weight gain (12.5%). ENDOSCOPIC FINDINGS: All had abnormal endoscopic findings on esophago-gastro-duodenoscopy (EGD), most commonly gastric nodularity (77.5%), visible blood (20%), erosions/superficial ulcerations (10%), ulcers (7.5%). Histologically, all patients had increased subepithelial collagen deposition. TREATMENT: A variety of medications aimed towards inflammation and symptomatic treatment were used. Patients with anemia received iron supplementation and responded. Otherwise, there was no significant association of clinical or histologic improvement with specific treatments. CLINICAL AND HISTOLOGIC OUTCOMES: 87.5% reported improvement or resolution of symptoms at the last follow-up (34.8 ±â€Š27.0 months). Persistent sub-epithelial collagen was noted in 73.1% on the last EGD. CONCLUSIONS: Despite persistent findings of increased sub-epithelial collagen deposition during the follow-up period, most patients with CG show remission or resolution of clinical symptoms. Anemia responds to iron supplementation in all patients.

Collagenous Gastritis in Children: Incidence, Disease Course, and Associations With Autoimmunity and Inflammatory Markers.

INTRODUCTION: Collagenous gastritis (CG), a rare disorder of unknown etiology, has been postulated to have immune-mediated mechanisms. We investigated (i) the incidence and prevalence of CG in a pediatric population; (ii) the clinical, endoscopic, and histologic characteristics of childhood-onset CG; and (iii) the evidence for autoimmunity and/or inflammatory activity in these patients. METHODS: Clinical, endoscopic, and histologic data were reviewed longitudinally in a population-based Swedish cohort of 15 patients with childhood-onset CG diagnosed in the period 2008-2019. A set of 11 autoantibodies, 4 blood inflammatory biomarkers, and the human leukocyte antigen DQ2/DQ8 genotype was analyzed cross-sectionally. RESULTS: The incidence rate of childhood-onset CG was 0.25/100,000 person-years, with an incidence rate ratio of girls to boys of 4.2 (95% confidence interval, 1.2-15). The prevalence of CG was 2.1/100,000 in children aged younger than 18 years. The endoscopic and histologic findings remained pathologic in all the examined patients during a median follow-up of 4.4 years. Many patients had heredity for autoimmune disorders (47%) and/or tested positive for autoantibodies (40%) or human leukocyte antigen DQ2/DQ8 (53%). No associated autoimmune comorbidities were observed. The serum levels of calprotectin and amyloid A were increased in 10/15 (67%) and 5/15 (33%) of the patients, respectively, whereas plasma C-reactive protein levels were normal in all, but 1 patient. DISCUSSION: The results indicate that childhood-onset CG is rare and has a chronic disease course. Although signs of autoimmune predisposition are frequent, early development of autoimmune comorbidities seems seldom. Serum calprotectin and amyloid A represent novel candidate biomarkers of inflammatory activity in CG (see Visual Abstract, Supplementary Digital Content 4, http://links.lww.com/CTG/A349).

Eosinophilic Gastrointestinal Disorders.

Eosinophilic gastrointestinal disorders (EGID) are a group of disorders characterized by pathologic eosinophilic infiltration of the esophagus, stomach, small intestine, or colon leading to organ dysfunction and clinical symptoms (J Pediatr Gastroenterol Nutr; Spergel et al., 52: 300-306, 2011). These disorders include eosinophilic esophagitis (EoE), eosinophilic gastritis (EG), eosinophilic gastroenteritis (EGE), eosinophilic enteritis (EE), and eosinophilic colitis (EC). Symptoms are dependent not only on the location (organ) as well as extent (layer invasion of the bowel wall). Common symptoms of EoE include dysphagia and food impaction in adults and heartburn, abdominal pain, and vomiting in children. Common symptoms of the other EGIDs include abdominal pain, nausea, vomiting, early satiety, diarrhea, and weight loss. These disorders are considered immune-mediated chronic inflammatory disorders with strong links to food allergen triggers. Treatment strategies focus on either medical or dietary therapy. These options include not only controlling symptoms and bowel inflammation but also on identifying potential food triggers. This chapter will focus on the clinical presentation, pathophysiology, and treatment of these increasingly recognized disorders.

Iron deficiency anemia: clinical and etiological features.

BACKGROUND: Iron deficiency is the most common nutritional deficiency worldwide and its resulting anemia appears as a public health problem. Iron deficiency anemia is rather a symptom than a disease in itself, and the identification of its etiology is of paramount importance. AIM:   to study the clinical and etiological features of iron deficiency anemia in an Internal Medicine department. METHODS: We conducted a retrospective descriptive study between 2001 and 2015 at an internal medicine department including patients presenting with iron deficiency anemia and having at least one etiological investigation. RESULTS: The average age was 45.6  16,3 years. Three main mechanisms of iron deficiency anemia were noted: repeated blood loss (94.4%), digestive malabsorption of iron (17.8%) and lack of dietary iron intake (6.6%). The digestive origin dominated the etiologies of iron deficiency anemia with a leading frequency of gastritis (32.2%). An underlying cancer was discovered in six cases. The average duration of follow-up was 9.1 months. An unfavorable outcome (persistence or recurrence of iron deficiency anemia) was associated with an absence or insufficiency of etiological treatment (p << 10-3) and with a duration of iron treatment inferior to 4 months (p = 0.034). CONCLUSION: In case of iron deficiency anemia, the prognosis depends on the quality of the etiological investigation. It can allow the discovery of an underlying cancer. The management of iron deficiency anemia relies on a well-led iron supplementation and an optimal treatment of the incriminated cause.

Association between khat chewing and gastrointestinal disorders: a cross sectional study.

BACKGROUND: Khat (Catha edulis Forsk) is a psycho-stimulant substance grown in East Africa. But its adverse effects and its prevalence are not well studied. The main aim of the present study is thus to assess the association between khat chewing and GI problems among students in Ambo University. METHODS: A cross-sectional study was conducted in January 2010 on 1005 Ambo University students. Study subjects were selected using systematic random sampling technique, and data were collected using self-administered questionnaire. Data analysis was made using SPSS version 16.0 for windows package. RESULTS: The mean age of the respondents was 20.79 ± 1.39 ranging from 18-30 years. Seven hundred twenty (71.6 %) of the study participants were males and 994 (98.9%) were in the age group of 15-24 years. The prevalence of gastritis was 580 (57.7%); constipation 235 (23.4%); hemorrhoids 54 (5.4%) and that of dental problems (carries, decay, filling and extraction) was 225 (22.4%) of all study participants. Gastrointestinal disorders were found to be higher among khat chewers, where 64(36.2%) of them had dental problems; 127(71.8%) symptoms of gastritis; 86(48.6%) constipation and 26(14.7%) hemorrhoids which demonstrated statistically significant association with p < 0.001. CONCLUSION: The prevalence of gastrointestinal disorders was found to be higher among khat chewers, indicating that khat chewing could be a predisposing factor to gastrointestinal disorders. Community-based awareness creation about the adverse effect of khat use is thus recommended.

[Rehabilitation treatment of patients with erosive-ulcerative lesions in the gastroduodenal system in sanatorium conditions].

The present study has demonstrated that the treatment of patients with erosive-ulcerative lesions in the gastroduodenal system at the stages of after-treatment and rehabilitation based on the combined application of natural curative factors and essential phospholipids makes to possible to increase the efficiency of therapy by 18-20% compared with control.

Protective effect of green tea on the risks of chronic gastritis and stomach cancer.

Despite the declining trend, stomach cancer remains the second most common cancer worldwide. We examined the role of green tea consumption on chronic gastritis and stomach cancer risks. A population-based case-control study was conducted in Yangzhong, China, with 133 stomach cancer cases, 166 chronic gastritis cases, and 433 healthy controls. Epidemiologic data were collected by standard questionnaire and odds ratios (OR) and 95% confidence intervals (CI) were estimated using logistic regression models in SAS. Inverse association was observed between green tea drinking and chronic gastritis and stomach cancer risks. After adjusting for age, gender, education, body mass index, pack-years of smoking and alcohol drinking, ORs of green tea drinking were 0.52 (95% CI: 0.29-0.94) and 0.49 (95% CI: 0.31-0.77) for stomach cancer and chronic gastritis, respectively. In addition, dose-response relationships were observed with years of green tea drinking in both diseases. The results provide further support on the protective effect of green tea against stomach cancer. This is the first time that green tea drinking was found to be protective against chronic gastritis, which may be of importance when designing intervention strategies for stomach cancer and its pre-malignant lesions in the high-risk population.

The prevalence and significance of occult blood loss in patients with predialysis advanced chronic renal failure (CRF), or receiving dialytic therapy.

Hemoccult test was performed on stool specimens of 249 patients; 64 with advanced renal failure prior to dialysis (CRF), 144 on maintenance hemodialysis (HD), and 41 receiving chronic ambulatory peritoneal dialysis CAPD. Each patient collected spontaneously evacuated stool specimens on three different days. None of the patients had overt gastrointestinal bleeding prior to participation in the study. The patients were not taking aspirin, or any other ulcerogenic medication, nor receiving iron supplements at the time of study. Twelve of 64 CRF patients (18.8%), 9 of 144 HD subjects (6.3%), and 3 of 41 CAPD patients (7.3%) had Hemoccult positive stool. Twenty patients underwent diagnostic gastrointestinal (GI) evaluation and these studies demonstrated a definite GI pathology. The commonest lesion was duodenal involvement (alone or in combination with other lesions) and was found in 61.1% of the subjects. The duodenal lesions consisted of superficial erosions, duodenitis, ulcers, polyp, and arteriovenous malformation. The other common lesions were gastritis and hemorrhoids. These results underscore the need for utilization of a simple and non-invasive Hemoccult test in patients with ESRD routinely, and the positive test should be followed by a thorough gastrointestinal work up to identify the cause of occult bleeding.

[Diagnosis, prevention and treatment of postoperative reflux gastritis]. / Diagnostika, profilaktika i lechenie posleoperatsionnogo refliuks-gastrita.

Postoperative reflux gastritis in persons who were operated on for peptic ulcer occurs much more frequently after resection of the stomach (68.6%) than after organ-preserving operations on the stomach (39.4%). The incidence of reflux gastritis after gastric resection depends on the type of gastroenteroanastomosis. It is encountered much less frequently after Roux' operation (9.2%). The pronounced character and frequency of reflux gastritis after organ-preserving operations on the stomach are determined by the type of stomach-draining operations, the localization of the ulcer before the operation, whether in the stomach or the duodenum, the existence of duodenogastric reflux (DGR) before the operation. Measures for the prevention of postoperative reflux gastritis in the management of peptic ulcer are as follows: (a) wide introduction of organ-preserving operations, preferably SPV by itself or in combination with duodenoplasty; (b) formation of Roux' gastroenteroanastomosis when resection of the stomach is indicated. Reflux gastritis must be treated by nonoperative methods, including medicinal, dietetic, and spa therapy. Surgery is indicated in reflux gastritis combined with other diseases of a stomach which had been operated on, for which an operation is necessary, and in occasional cases of erosive reflux gastritis.

[The value of imaging techniques in the diagnosis of non-specific abdominal pain in young patients]. / Wertigkeit bildgebender Verfahren bei der Diagnostik unspezifischer abdomineller Beschwerden junger Patienten.

In a retrospective study the use of imaging modalities in the diagnosis of non-specific abdominal pain in patients under 31 years was evaluated. 253 patients with primarily non-specific abdominal complaints were analysed. For further investigation one of the following methods had to be applied: abdominal sonography and/or upper gastrointestinal tract roentgenograms and/or enteroclysis and/or barium enema. In 66% (167/253) of all cases abdominal pain remained non-specific. Clinical history and physical examination led to the final diagnosis in 66/86 (76.7%) of patients with pathologic findings. 21/561 (3.7%) radiographic examinations revealed abnormalities of clinical importance. In 10/253 (4%) patients the final diagnosis could be established only with the help of radiologic and/or endoscopic examinations. The low efficacy of conventional radiology justifies the demand for a stricter indication in the young patient suffering from non-specific abdominal pain.

[Helicobacter pylori and nonsteroidal antirheumatics]. / Helicobacter pylori und nicht-steroidale Antirheumatika.

The frequency of occurrence of Helicobacter pylori in the antral mucosa was investigated prospectively in a group of 66 patients (17 men, 49 women, mean age 58 +/- 8.4 years) who had been treated with nonsteroidal anti-rheumatic drugs and 33 controls (14 men, 19 women, mean age 60.7 +/- 6.6 years) who had not received these drugs. In the first group the indication for gastroscopy was ingestion of nonsteroidal antirheumatic drugs for at least 8 weeks, irrespective of dyspeptic symptoms (present in 25 patients), while in the second group the reason for endoscopy was either clinical symptoms (n = 18) or the presence of blood in the faeces. Helicobacter pylori was demonstrated by culture in 36 out of the 66 patients who had received nonsteroidal antirheumatics (54.5%); these comprised 24 out of 46 patients (52.2%) with chronic inactive gastritis and 12 out of 15 patients (80%) with chronic active gastritis. In the control group H. pylori was detected by culture in 22 out of 33 patients (66.7%); these included 11 out of 19 patients (57.9%) with chronic inactive gastritis and 11 out of 12 patients (91.7%) with chronic active gastritis. H. pylori was not demonstrated in any of the seven patients who had histologically normal gastric mucosa. In both groups there was significant correlation between demonstration of the microorganism and severity of inflammation. There is hence no evidence that nonsteroidal antirheumatic drugs have any influence on the colonisation of the antral mucosa by Helicobacter pylori.