Dyspepsia-Like Symptoms in Helicobacter pylori-Negative Chronic Gastritis are Associated with Celiac Seropositivity

Celiac.com 12/05/2022 - Helicobacter pylori (H. pylori) is one possible cause for dyspepsia. However, dyspeptic symptoms are also common in H. pylori negative gastritis. Understanding the underlying causes could help improve treatment strategies for dyspepsia and chronic gastritis. 

A team of researchers recently set out to assess rates of dyspeptic symptoms in patients with H. pylori negative chronic gastritis, and explore any potential role played by autoimmunity.

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The research team included Noémi Zádori, Dávid Németh, Levente Frim, Nóra Vörhendi, Lajos Szakó, Szilárd Váncsa, Péter Hegyi, and József Czimmer.

They are variously affiliated with the Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary; the János Szentágothai Research Centre, University of Pécs, Pécs, Hungary; the Centre for Translational Medicine, Semmelweis University, Budapest, Hungary; the Division of Gastroenterology, First Department of Medicine, Medical School, University of Pécs, Pécs, Hungary

For their retrospective study, the team included data from patients with H. pylori negative chronic gastritis. They excluded: patients with acute gastritis; reactive gastropathy; subjects without serology test results; H. pylori positivity; presence of atrophy, intestinal metaplasia (IM), gastroesophageal reflux disease (GERD), ulcer, or cancer. 

The researchers assessed the following endpoints:

1. the rate of dyspepsia-like symptoms;
2. links between dyspepsia and autoimmune disease-related seromarker positivity (AISP);
3. frequency of other symptoms in chronic gastritis and its association with AISP; and
4. location of the inflammation and its association with AISP.

For their study, the team included 175 from a total of 285 patients. A total of ninety-five of these 175 patients, nearly 55%, experienced dyspeptic symptoms.

Overall, AISP was more common in these dyspeptic patients, especially celiac seropositivity, anti-neutrophil cytoplasmic antibody (ANCA) and anti-Saccharomyces cerevisiae antibodies (ASCA) positivity. The team found no significant connections with other tested autoimmune (AI)-related antibody positivity.

Having positive seromarkers for autoimmune diseases in chronic gastritis may make people susceptible to dyspeptic symptoms, and may be the cause of many cases of dyspepsia. 

According to their findings: "From a total of 285 patients, 175 were included in this study. Among these patients, 95 experienced dyspeptic symptoms (54.29%) and were associated more with AISP (p = 0.012), especially with celiac seropositivity (p = 0.045), anti-neutrophil cytoplasmic antibody (ANCA) and anti-Saccharomyces cerevisiae antibodies (ASCA) positivity (p = 0.043). A significant association was not found with other tested autoimmune (AI)-related antibody positivity."

The data suggest that additional studies will help to clarify whether antibody screening in patients with dyspepsia will help shrink the time for autoimmune disease diagnoses, and whether screening is economically and medically beneficial.

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