Helicobacter Pylori and Celiac Disease Antibody Positivity More Common in Patients With Distal Gastrectomy

Celiac.com 08/23/2023 - Distal gastrectomy has been a common treatment for peptic ulcers and gastroesophageal reflux disease. However, questions have arisen about its impact on gastric mucosa. 

A team of researchers recently looked into the connection between distal gastrectomy and Helicobacter pylori infection, as well as celiac disease. The research team included Kubilay Issever, Ersin Kuloglu, Demet Sengul, Ali Muhtaroglu, and Ahmet Cumhur Dulger. They are variously affiliated with the departments of Internal Medicine, Pathology, and General Surgery at Giresun University Medical Faculty in Giresun, Turkey.

Observational Retrospective Study Focused on Two Groups of Dyspepsia Patients

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Conducted at Giresun University Faculty of Medicine, the observational retrospective study focused on two groups of patients with dyspepsia. The first group, termed the antrectomy group, consisted of 35 individuals who had undergone distal gastrectomy for benign causes. The second, the control group, included 50 dyspepsia patients who had not undergone gastrectomy.

Results showed that the antrectomy group had a higher proportion of older male patients. Lab parameters revealed significant differences: platelets, lymphocytes, and albumin levels were lower in the antrectomy group, while urea, creatinine, and antibodies like anti-Endomisium Ig A (anti-EMA) and anti-tissue transglutaminase IgA (anti-tTGA) were higher. Gastric biopsy results unveiled greater instances of Helicobacter pylori infection, tissue atrophy, neutrophil, and lymphocyte infiltration in the antrectomy group compared to the control group.

Further analysis showed correlations of note. An inverse relationship was found between albumin levels and the presence of anti-EMA antibodies or tissue atrophy. Conversely, a positive correlation existed between anti-EMA antibody presence and both Helicobacter pylori infection and tissue atrophy.

Distal Gastrectomy for Dyspepsia Patients More Likely to Have Helicobacter Pylori Infection and Celiac Disease

The study's implications are significant. People who have undergone distal gastrectomy for dyspepsia may be more susceptible to complications tied to Helicobacter pylori infection and celiac disease. The potential for Helicobacter pylori infections to progress into malignancies raises concerns. As a result, routine screening and interventions to eliminate Helicobacter pylori infections are paramount to prevent malignant transformations in the remaining gastric tissue.

This study underscores the potential risks stemming from distal gastrectomy, especially its association with Helicobacter pylori infection and celiac disease. This knowledge will help medical practitioners to better navigate post-gastrectomy care, more effectively manage potential complications, and better plan preventive measures.

This study does not indicate whether the increased celiac disease risk was a result of the distal gastrectomy, or whether the patients who underwent a distal gastrectomy may have had undiagnosed celiac disease before this treatment. Logically the results of this study might indicate that routine screenings for celiac disease should be done before any distal gastrectomy surgery to rule it out. 

Read more at Cureus.com