Cargando…

White opaque substance visualized by magnifying narrow-band imaging is associated with intragastric acid conditions

BACKGROUND AND STUDY AIMS:  The presence of white opaque substance (WOS) is an endoscopic marker of intestinal metaplasia. Considering that the nature of WOS is absorbed lipid droplets, lipase plays an important role in the lipid absorption process and is inactivated at strong acidity. WOS may only...

Descripción completa

Detalles Bibliográficos
Autores principales: Togo, Kazumi, Ueo, Tetsuya, Yao, Kenshi, Wada, Kurato, Honda, Hideho, Inoue, Syotaro, Fukuda, Masahide, Yanai, Yuka, Yonemasu, Hirotoshi, Murakami, Kazunari
Formato: Online Artículo Texto
Lenguaje:English
Publicado: © Georg Thieme Verlag KG 2018
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6031444/
https://www.ncbi.nlm.nih.gov/pubmed/29978002
http://dx.doi.org/10.1055/a-0611-4825
_version_ 1783337318650740736
author Togo, Kazumi
Ueo, Tetsuya
Yao, Kenshi
Wada, Kurato
Honda, Hideho
Inoue, Syotaro
Fukuda, Masahide
Yanai, Yuka
Yonemasu, Hirotoshi
Murakami, Kazunari
author_facet Togo, Kazumi
Ueo, Tetsuya
Yao, Kenshi
Wada, Kurato
Honda, Hideho
Inoue, Syotaro
Fukuda, Masahide
Yanai, Yuka
Yonemasu, Hirotoshi
Murakami, Kazunari
author_sort Togo, Kazumi
collection PubMed
description BACKGROUND AND STUDY AIMS:  The presence of white opaque substance (WOS) is an endoscopic marker of intestinal metaplasia. Considering that the nature of WOS is absorbed lipid droplets, lipase plays an important role in the lipid absorption process and is inactivated at strong acidity. WOS may only be present in a hypochlorhydria state following Helicobacter pylori infection, and, thus, may not be highly sensitive marker, especially in H. pylori- eradicated patients. We investigated the relationship between WOS and gastric acid conditions. PATIENTS AND METHODS:  A total of 501 patients were retrospectively evaluated for the presence of WOS at 2 regions of interest using magnifying narrow-band imaging. The pH level of collected gastric juice was also measured. Study end points were (1) prevalence of WOS and its relationship with gastric juice pH in 3 groups: H. pylori- uninfected , H. pylori- infected, and H. pylori -eradicated; (2) the relationship between prevalence of WOS and gastric juice pH before and after proton pump inhibitor (PPI) administration in 29 H. pylori -eradicated cases. RESULTS:  Prevalence of WOS was 0 % (0 /206), 28.4 % (31/109), and 3.2 % (6/186) in the H. pylori -uninfected, H. pylori -infected, and H. pylori -eradicated groups, respectively. Mean gastric juice pH was significantly higher in WOS-positive cases than in WOS-negative cases in the H. pylori -infected and H. pylori -eradicated groups ( P  < 0.0001). Mean gastric juice pH increased from 1.1 to 6.9 after PPI administration and WOS prevalence increased from 0 % (0/29) to 45 % (13/29) of cases. CONCLUSION:  The prevalence of WOS is closely associated with the neutralization of intragastric pH.
format Online
Article
Text
id pubmed-6031444
institution National Center for Biotechnology Information
language English
publishDate 2018
publisher © Georg Thieme Verlag KG
record_format MEDLINE/PubMed
spelling pubmed-60314442018-07-05 White opaque substance visualized by magnifying narrow-band imaging is associated with intragastric acid conditions Togo, Kazumi Ueo, Tetsuya Yao, Kenshi Wada, Kurato Honda, Hideho Inoue, Syotaro Fukuda, Masahide Yanai, Yuka Yonemasu, Hirotoshi Murakami, Kazunari Endosc Int Open BACKGROUND AND STUDY AIMS:  The presence of white opaque substance (WOS) is an endoscopic marker of intestinal metaplasia. Considering that the nature of WOS is absorbed lipid droplets, lipase plays an important role in the lipid absorption process and is inactivated at strong acidity. WOS may only be present in a hypochlorhydria state following Helicobacter pylori infection, and, thus, may not be highly sensitive marker, especially in H. pylori- eradicated patients. We investigated the relationship between WOS and gastric acid conditions. PATIENTS AND METHODS:  A total of 501 patients were retrospectively evaluated for the presence of WOS at 2 regions of interest using magnifying narrow-band imaging. The pH level of collected gastric juice was also measured. Study end points were (1) prevalence of WOS and its relationship with gastric juice pH in 3 groups: H. pylori- uninfected , H. pylori- infected, and H. pylori -eradicated; (2) the relationship between prevalence of WOS and gastric juice pH before and after proton pump inhibitor (PPI) administration in 29 H. pylori -eradicated cases. RESULTS:  Prevalence of WOS was 0 % (0 /206), 28.4 % (31/109), and 3.2 % (6/186) in the H. pylori -uninfected, H. pylori -infected, and H. pylori -eradicated groups, respectively. Mean gastric juice pH was significantly higher in WOS-positive cases than in WOS-negative cases in the H. pylori -infected and H. pylori -eradicated groups ( P  < 0.0001). Mean gastric juice pH increased from 1.1 to 6.9 after PPI administration and WOS prevalence increased from 0 % (0/29) to 45 % (13/29) of cases. CONCLUSION:  The prevalence of WOS is closely associated with the neutralization of intragastric pH. © Georg Thieme Verlag KG 2018-07 2018-07-04 /pmc/articles/PMC6031444/ /pubmed/29978002 http://dx.doi.org/10.1055/a-0611-4825 Text en https://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License, which permits unrestricted reproduction and distribution, for non-commercial purposes only; and use and reproduction, but not distribution, of adapted material for non-commercial purposes only, provided the original work is properly cited.
spellingShingle Togo, Kazumi
Ueo, Tetsuya
Yao, Kenshi
Wada, Kurato
Honda, Hideho
Inoue, Syotaro
Fukuda, Masahide
Yanai, Yuka
Yonemasu, Hirotoshi
Murakami, Kazunari
White opaque substance visualized by magnifying narrow-band imaging is associated with intragastric acid conditions
title White opaque substance visualized by magnifying narrow-band imaging is associated with intragastric acid conditions
title_full White opaque substance visualized by magnifying narrow-band imaging is associated with intragastric acid conditions
title_fullStr White opaque substance visualized by magnifying narrow-band imaging is associated with intragastric acid conditions
title_full_unstemmed White opaque substance visualized by magnifying narrow-band imaging is associated with intragastric acid conditions
title_short White opaque substance visualized by magnifying narrow-band imaging is associated with intragastric acid conditions
title_sort white opaque substance visualized by magnifying narrow-band imaging is associated with intragastric acid conditions
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6031444/
https://www.ncbi.nlm.nih.gov/pubmed/29978002
http://dx.doi.org/10.1055/a-0611-4825
work_keys_str_mv AT togokazumi whiteopaquesubstancevisualizedbymagnifyingnarrowbandimagingisassociatedwithintragastricacidconditions
AT ueotetsuya whiteopaquesubstancevisualizedbymagnifyingnarrowbandimagingisassociatedwithintragastricacidconditions
AT yaokenshi whiteopaquesubstancevisualizedbymagnifyingnarrowbandimagingisassociatedwithintragastricacidconditions
AT wadakurato whiteopaquesubstancevisualizedbymagnifyingnarrowbandimagingisassociatedwithintragastricacidconditions
AT hondahideho whiteopaquesubstancevisualizedbymagnifyingnarrowbandimagingisassociatedwithintragastricacidconditions
AT inouesyotaro whiteopaquesubstancevisualizedbymagnifyingnarrowbandimagingisassociatedwithintragastricacidconditions
AT fukudamasahide whiteopaquesubstancevisualizedbymagnifyingnarrowbandimagingisassociatedwithintragastricacidconditions
AT yanaiyuka whiteopaquesubstancevisualizedbymagnifyingnarrowbandimagingisassociatedwithintragastricacidconditions
AT yonemasuhirotoshi whiteopaquesubstancevisualizedbymagnifyingnarrowbandimagingisassociatedwithintragastricacidconditions
AT murakamikazunari whiteopaquesubstancevisualizedbymagnifyingnarrowbandimagingisassociatedwithintragastricacidconditions