Endoscopic findings for predicting gastric acid secretion status

Waku Hatta, Katsunori Iijima, Tomoyuki Koike, Yutaka Kondo, Nobuyuki Ara, Kiyotaka Asanuma, Kaname Uno, Naoki Asano, Akira Imatani, Tooru Shimosegawa

Research output: Contribution to journalArticlepeer-review

17 Citations (Scopus)


Background and Aim Gastric acidic abnormalities are related to various types of diseases in Helicobacter pylori (H.pylori) infection status. However, no studies have shown correlations between many tiny endoscopic findings and the acid secretion level simultaneously. In the present study, we investigated predictive tiny endoscopic findings of hyperchlorhydria and hypochlorhydria. Methods A total of 223 subjects without organic diseases who underwent esophagogastroduodenoscopy and endoscopic gastrin test (EGT) for estimating gastrin-stimulated gastric acid secretory response between 1999 and 2012 at our institution were retrospectively analyzed. Two blinded expert endoscopists reviewed the images independently and recorded the endoscopic findings. Results According to the EGT values, the enrolled subjects were categorized into hyperchlorhydria, normal acid secretion, and hypochlorhydria groups. In all subjects, hematin (odds ratio [95% confidence interval]=3.32 [1.40-7.84]) and antral erosion(2.88 [1.24-6.70]) were the predictive endoscopic findings for hyperchlorhydria, and swelling of areae gastricae (14.4 [5.74-36.1]) and open-type atrophy (15.1 [7.35-31.1]) were those for hypochlorhydria. In addition, the predictive endoscopic findings for hyperchlorhydria differed according to the H.pylori infection status, hematin in H.pylori-positive subjects and antral erosion in H.pylori-negative subjects, in contrast to those for hypochlorhydria, which were the same irrespective of the H.pylori infection status. Conclusions We could predict the acid secretion status based on the endoscopic findings regardless of H.pylori infection status, which would be of some help for evaluating the risk for acid-related diseases.

Original languageEnglish
Pages (from-to)582-589
Number of pages8
JournalDigestive Endoscopy
Issue number5
Publication statusPublished - 2015 Jul 1


  • Helicobacter pylori
  • endoscopy
  • gastric acid
  • hyperchlorhydria
  • hypochlorhydria


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