Browsing by Author "Suranimala, H.D.C."

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    Gastric disease in patients presenting with dyspeptic symptoms
    (Sri Lanka Medical Association, 2002) Hewavisenthi, S.J.de S.; Suranimala, H.D.C.; Alwis, W.H.D.
    INTRODUCTION: Upper gastrointestinal endoscopy and biopsy is a relatively common procedure that is now frequently used in the investigation of patients with 'dyspeptic symptoms'. OBJECTIVES: To correlate the endoscopic findings with histological features. To ascertain patterns of gastric disease occurring in patients undergoing upper gastrointestinal endoscopy and biopsy for dyspeptic symptoms. METHODS: 419 endoscopic biopsies performed on patients with dyspeptic symptoms during the period April 2000 to October 2001 were reviewed. In all patients biopsies were performed on an area of the gastric mucosa showing an endoscopic abnormality. The patients included 258 males and 161 females with ages ranging from 11-86 years (median 45.5). Most biopsies were obtained from the antral region (322/419). RESULTS: 110/419 (26%) biopsies were histologically normal despite an 'endoscopic abnormality' being reported. 15 biopsies (3.5%) were non-diagnostic due to biopsy artefacts, poor preservation and other factors. 13/419 (3%) biopsies revealed neoplastic lesions (11- malignant, 2-fundic gland cysts). Of the non neoplastic gastric disorders 33 (7.9%) were peptic ulcers, 202 (48%) chronic gastritis, 40 (9.5%) reactive gastritis, 6 (1%) portal gastropathy, 1 hyperplastic gastropathy. Helicobactorpylori was identified in 112/202 (55%) of the biopsies with chronic gastritis. CONCLUSIONS: Endoscopic and histologic correlation was satisfactory in a majority, 74% of the biopsies showing histological evidence of disease. Helicobactor pylori induced gastritis was the commonest (27%) pathology encountered in patients investigated for dyspeptic symptoms.
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    Histological evaluation and H. pylori status of dyspeptic patients without gastrooesophageal reflux
    (College of Surgeons of Sri Lanka, 2004) Hewavisenthi, S.J.de S.; Suranimala, H.D.C.; Alwis, W.H.E.; Senevirathne, K.A.D.C.
    OBJECTIVE: To identify different types of gastric pathology in patients with dyspeptic symptoms without gastro oesophageal reflux, to assess the prevalence of H, pylori in their biopsies and to correlate the histological changes with the presence of these organisms. METHOD: 788 dyspeptic patients were included in the study during the period April 2000 - August 2002. Their gastric biopsies were reviewed and diagnoses were classified as normal, chronic gastritis, reactive gastritis, portal gastropathy, peptic ulcer, neoplastic and others. 22 non diagnostic biopsies were excluded. The biopsies in which H. pylori was identified were graded histologically as mild, moderate and severe for organism density, chronic inflammation, activity, intestinal metaplasia and glandular atrophy in accordance with the updated Sydney classification. RESULTS: Gastric pathology identified in the dyspeptic patients studied included normal (187), chronic gastritis (373), reactive gastritis (50), portal gastropathy (9), peptic ulcers including both gastric and duodenal ulcers (128), neoplastic (15) and others (4). H pylori was identified in 210 patients. 189 (90%) of these were associated with chronic gastritis. Chronic inflammation in gastric biopsies was graded as mild in 75, moderate in 104, severe in 31 and activity was graded as absent in 45, mild in 115, moderate in 3 8 and severe in 12. Associated intestinal metaplasia was present in 32/210 > ymild (26), moderate (6)?y and glandular atrophy was present in 42/210 (mild (36), moderate (8)). H .pylori density was mild in 165, moderate in 39 and severe in 6. The H. pylori density showed a significant correlation with inflammation and activity. CONCLUSION: Chronic gastritis was the single most common condition diagnosed in dyspeptic patients without gastro oesophageal reflux. Overall, H. pylori was identified in 27.4% of dyspeptic patients. In most biopsies chronic inflammation was moderate and activity was mild or absent, and this was associated with a low H. pylori density. The incidence of metaplasia and glandular atrophy was low.