Evaluation of Gastro-Duodenal (GD) Mucosa of Non-IBS / Non-EGD Disorders in Calculous Cholecystitis and Dyslipidemia
DOI:
https://doi.org/10.67440/ahj.vi.2586Keywords:
Irritable bowel syndrome; Non-IBS; Chronic calculous cholecystitis; Dyslipidemia; Gastro-duodenal mucosa; Lymphocytic infiltration; Upper gastrointestinal endoscopy.Abstract
Background: Irritable bowel syndrome (IBS) is a disorder of gut-brain interaction in which low-grade mucosal immune activation may contribute to symptoms. Chronic calculous cholecystitis (CCC) and dyslipidemia may also be associated with microscopic gastro-duodenal inflammation.
Aim of the work: To assess gastro-duodenal mucosal histopathological changes in IBS versus non-IBS patients in relation to CCC and dyslipidemia.
Methods: This cross-sectional study included 153 symptomatic adults undergoing upper gastrointestinal endoscopy and mucosal biopsy. Patients were classified as IBS (n=63) or non-IBS (n=90). Overlapping exposure strata were CCC (n=45), dyslipidemia (n=32), and no CCC/no dyslipidemia (n=95).
Results: Among IBS patients, moderate gastric lymphocytic infiltration was more frequent with dyslipidemia (78.6%) and CCC (65.5%) than with neither exposure (25.8%), with significant comparisons for dyslipidemia versus unexposed patients (P=0.001) and CCC versus unexposed patients (P=0.004). Average gastric infiltration was more frequent in unexposed IBS patients than in the CCC or dyslipidemia strata (both P<0.001). No significant gastric pairwise differences were detected among non-IBS patients. Duodenal differences were less robust; average infiltration was higher in unexposed than dyslipidemic IBS patients (48.4% vs 14.3%, P=0.046).
Conclusion: CCC and dyslipidemia were associated with selected microscopic gastro-duodenal inflammatory changes, most clearly gastric lymphocytic infiltration in IBS patients. These exploratory findings require prospective validation.
