DEVELOPMENT OF GASTRIC AND DUODENAL ULCER IN RELATION TO ANTRAL AND FUNDAL GASTRITIS

Abstract

The extent of fundal gastritis and the grade of antral gastritis in patients with duodenal ulcer and coexisting gastroduodenal ulcers were examined by the endoscopic Congored test. Forty-two patients with duodenal ulcer were followed up by the chromoendoscopy to investigate the location of gastric ulcers developing during a mean observation period of 3 years and 4 months in relation to the changes of fundal and antral gastritis. There was a significant difference between the extent of fundal gastritis and the grade of antral gastritis in patients with duodenal ulcer and coexisting gastroduodenal ulcers. Duodenal ulcers were associated with slight antral gastritis and without fundal gastritis. In the coexisting duodenal and antral ulcers, fundal gastritis was about the same in severity as that in duodenal ulcers, but antral gastritis was usually severe. In contrast, fundal and antral gastritis were both severe in the coexisting duodenal and high lying ulcer. Follow-up studies showed that there was a significant relationship between the development of gastric ulcers and the changes of antral and fundal gastritis. Gastric ulcers developed in the antrum or the angulus in patients with duodenal ulcer when antral gastritis became worse, but not fundal gastritis, and that when fundal gastritis extended, ulcers developed in the gastric body. In conclusion, the sites of gastric and duodenal ulcers were determined by the extent of fundal gastritis and the grade of antral gastritis.