Investigation of the extent of gastric metaplasia in the duodenal bulb by using methylene blue staining

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Abstract

Background and Aims: The existence of gastric metaplasia (GM) of the duodenal mucosa has been considered to be highly related to the recurrence of duodenal ulcers (DU). The aims of this study are to evaluate the usefulness of methylene blue staining in the detection of GM, and to clarify the relationship between GM and the deformity of the duodenal bulb. Methods: Fifteen patients with healed DU and four patients with symptoms of dyspepsia without evidence of ulcers were enrolled into this endoscopic study. During each endoscopy, methylene blue was sprayed evenly on the duodenal bulb, and biopsies were taken from blue-stained and unstained areas. The existence and extent of GM were assessed histologically and grossly. The correlation between duodenal bulb deformity and the extent of GM was also studied. Results: The mean score of methylene blue non-staining (MBNS) was 0, 1.30 ± 0.15, and 3.00 ± 0.00 in group A (non-ulcer patients), group B (patients with healed DU and with normal-shaped bulb) and C (patients with healed DU and with deformed duodenal bulb), respectively; showing significant differences among the groups (P <0.05 in each). Both the existence and the grading of GM were higher in unstained specimens than in blue-stained specimens (100 vs 16.6%, P <0.0001 and 3.62 ± 0.09 vs 0.19 ± 0.06, P <0.001, respectively). Conclusions: Methylene blue non-staining can be applied to investigate the existence and extent of GM in the duodenal bulb accurately. The incidence of GM in the duodenal bulb was higher in patients with healed ulcers than in non-ulcer patients. Patients with deformed duodenal bulbs have a higher extent of GM than those without deformed duodenal bulbs.

Original languageEnglish
Pages (from-to)729-733
Number of pages5
JournalJournal of Gastroenterology and Hepatology (Australia)
Volume16
Issue number7
DOIs
Publication statusPublished - 2001

Fingerprint

Methylene Blue
Metaplasia
Stomach
Staining and Labeling
Duodenal Ulcer
Ulcer
Dyspepsia
Endoscopy
Mucous Membrane
Biopsy
Recurrence
Incidence

Keywords

  • Duodenal ulcer
  • Gastric metaplasia
  • Methylene blue

ASJC Scopus subject areas

  • Gastroenterology
  • Hepatology

Cite this

@article{11f766d94d074b1a8f34e8602d8a751b,
title = "Investigation of the extent of gastric metaplasia in the duodenal bulb by using methylene blue staining",
abstract = "Background and Aims: The existence of gastric metaplasia (GM) of the duodenal mucosa has been considered to be highly related to the recurrence of duodenal ulcers (DU). The aims of this study are to evaluate the usefulness of methylene blue staining in the detection of GM, and to clarify the relationship between GM and the deformity of the duodenal bulb. Methods: Fifteen patients with healed DU and four patients with symptoms of dyspepsia without evidence of ulcers were enrolled into this endoscopic study. During each endoscopy, methylene blue was sprayed evenly on the duodenal bulb, and biopsies were taken from blue-stained and unstained areas. The existence and extent of GM were assessed histologically and grossly. The correlation between duodenal bulb deformity and the extent of GM was also studied. Results: The mean score of methylene blue non-staining (MBNS) was 0, 1.30 ± 0.15, and 3.00 ± 0.00 in group A (non-ulcer patients), group B (patients with healed DU and with normal-shaped bulb) and C (patients with healed DU and with deformed duodenal bulb), respectively; showing significant differences among the groups (P <0.05 in each). Both the existence and the grading of GM were higher in unstained specimens than in blue-stained specimens (100 vs 16.6{\%}, P <0.0001 and 3.62 ± 0.09 vs 0.19 ± 0.06, P <0.001, respectively). Conclusions: Methylene blue non-staining can be applied to investigate the existence and extent of GM in the duodenal bulb accurately. The incidence of GM in the duodenal bulb was higher in patients with healed ulcers than in non-ulcer patients. Patients with deformed duodenal bulbs have a higher extent of GM than those without deformed duodenal bulbs.",
keywords = "Duodenal ulcer, Gastric metaplasia, Methylene blue",
author = "Chang, {Chun Chao} and Shiann Pan and Lien, {Gi Shih} and Sheng-Hsuan Chen and Cheng, {Chien Jui} and Jean-Dean Liu and Yeong-Shan Cheng and Suk, {Fat Moon}",
year = "2001",
doi = "10.1046/j.1440-1746.2001.02521.x",
language = "English",
volume = "16",
pages = "729--733",
journal = "Journal of Gastroenterology and Hepatology (Australia)",
issn = "0815-9319",
publisher = "Wiley-Blackwell",
number = "7",

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TY - JOUR

T1 - Investigation of the extent of gastric metaplasia in the duodenal bulb by using methylene blue staining

AU - Chang, Chun Chao

AU - Pan, Shiann

AU - Lien, Gi Shih

AU - Chen, Sheng-Hsuan

AU - Cheng, Chien Jui

AU - Liu, Jean-Dean

AU - Cheng, Yeong-Shan

AU - Suk, Fat Moon

PY - 2001

Y1 - 2001

N2 - Background and Aims: The existence of gastric metaplasia (GM) of the duodenal mucosa has been considered to be highly related to the recurrence of duodenal ulcers (DU). The aims of this study are to evaluate the usefulness of methylene blue staining in the detection of GM, and to clarify the relationship between GM and the deformity of the duodenal bulb. Methods: Fifteen patients with healed DU and four patients with symptoms of dyspepsia without evidence of ulcers were enrolled into this endoscopic study. During each endoscopy, methylene blue was sprayed evenly on the duodenal bulb, and biopsies were taken from blue-stained and unstained areas. The existence and extent of GM were assessed histologically and grossly. The correlation between duodenal bulb deformity and the extent of GM was also studied. Results: The mean score of methylene blue non-staining (MBNS) was 0, 1.30 ± 0.15, and 3.00 ± 0.00 in group A (non-ulcer patients), group B (patients with healed DU and with normal-shaped bulb) and C (patients with healed DU and with deformed duodenal bulb), respectively; showing significant differences among the groups (P <0.05 in each). Both the existence and the grading of GM were higher in unstained specimens than in blue-stained specimens (100 vs 16.6%, P <0.0001 and 3.62 ± 0.09 vs 0.19 ± 0.06, P <0.001, respectively). Conclusions: Methylene blue non-staining can be applied to investigate the existence and extent of GM in the duodenal bulb accurately. The incidence of GM in the duodenal bulb was higher in patients with healed ulcers than in non-ulcer patients. Patients with deformed duodenal bulbs have a higher extent of GM than those without deformed duodenal bulbs.

AB - Background and Aims: The existence of gastric metaplasia (GM) of the duodenal mucosa has been considered to be highly related to the recurrence of duodenal ulcers (DU). The aims of this study are to evaluate the usefulness of methylene blue staining in the detection of GM, and to clarify the relationship between GM and the deformity of the duodenal bulb. Methods: Fifteen patients with healed DU and four patients with symptoms of dyspepsia without evidence of ulcers were enrolled into this endoscopic study. During each endoscopy, methylene blue was sprayed evenly on the duodenal bulb, and biopsies were taken from blue-stained and unstained areas. The existence and extent of GM were assessed histologically and grossly. The correlation between duodenal bulb deformity and the extent of GM was also studied. Results: The mean score of methylene blue non-staining (MBNS) was 0, 1.30 ± 0.15, and 3.00 ± 0.00 in group A (non-ulcer patients), group B (patients with healed DU and with normal-shaped bulb) and C (patients with healed DU and with deformed duodenal bulb), respectively; showing significant differences among the groups (P <0.05 in each). Both the existence and the grading of GM were higher in unstained specimens than in blue-stained specimens (100 vs 16.6%, P <0.0001 and 3.62 ± 0.09 vs 0.19 ± 0.06, P <0.001, respectively). Conclusions: Methylene blue non-staining can be applied to investigate the existence and extent of GM in the duodenal bulb accurately. The incidence of GM in the duodenal bulb was higher in patients with healed ulcers than in non-ulcer patients. Patients with deformed duodenal bulbs have a higher extent of GM than those without deformed duodenal bulbs.

KW - Duodenal ulcer

KW - Gastric metaplasia

KW - Methylene blue

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U2 - 10.1046/j.1440-1746.2001.02521.x

DO - 10.1046/j.1440-1746.2001.02521.x

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JO - Journal of Gastroenterology and Hepatology (Australia)

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