Gastroenterology Unit, Department of Surgery, Oncology and Gastroenterology, University Hospital of Padua, Padua 35128, Italy.
Gastroenterology Unit, Department of Surgery, Oncology and Gastroenterology, University Hospital of Padua, Padua 35128, Italy.
Dig Liver Dis. 2020 Jun;52(6):615-624. doi: 10.1016/j.dld.2020.03.010. Epub 2020 Apr 12.
Beyond the small intestine, coeliac disease (CeD) may affect other gastrointestinal tracts, including the stomach. However, various studies have reported conflicting results regarding the association between CeD and gastric manifestations. The aim of this study was to analyze the existing literature on gastric involvement in CeD. A literature search was conducted in bibliographic databases of Embase, PubMed, Scopus, and Web of Science. Studies reporting the association between CeD and gastric disorders were examined in detail and are fully described in the review. Both in children and adults, a strong correlation between lymphocytic gastritis and CeD was found at CeD diagnosis, and lymphocytic gastritis seemed to improve on a gluten-free diet. Most of the literature described a lower risk of gastritis related to Helicobacter pylori infection in CeD subjects compared to controls. However, due to the discordance among studies in terms of study design and population, a clear association could not be determined. Finally, the relationship between CeD and reflux or dyspepsia has yet to be defined, as well as the association between CeD and autoimmune gastritis. CeD appears to be a multiform entity associated with different gastric disorders with a different degree of relationship. Thus, gastric biopsies should be routinely taken during upper endoscopy in CeD patients.
除了小肠,乳糜泻(CeD)还可能影响其他胃肠道,包括胃。然而,各种研究报告 CeD 与胃表现之间的关联结果相互矛盾。本研究旨在分析 CeD 中胃受累的现有文献。在 Embase、PubMed、Scopus 和 Web of Science 的文献数据库中进行了文献检索。详细检查了报告 CeD 与胃疾病之间关联的研究,并在综述中进行了全面描述。在儿童和成人中,在 CeD 诊断时发现淋巴细胞性胃炎与 CeD 之间存在很强的相关性,并且似乎在无麸质饮食上有所改善。大多数文献描述了与对照组相比,CeD 患者中与幽门螺杆菌感染相关的胃炎风险较低。然而,由于研究设计和人群方面的研究存在差异,因此无法确定明确的关联。最后,CeD 与反流或消化不良之间的关系以及 CeD 与自身免疫性胃炎之间的关系尚未确定。CeD 似乎是一种与不同程度相关的不同胃疾病相关的多态实体。因此,在 CeD 患者的上消化道内镜检查中应常规进行胃活检。