Search for: [Abstract = "Concentrated ethanol is one of many xenobiotics which cause injury to upper gastrointestinal tract mucosa but the mechanism of this action is still incompletely established. In cases of acute alcohol poisoning the direct necrotizing effect of consumed alcohol on the mucous membrane epithelium as well as the vascular reaction caused by vasoactive mediators \(histamine, leukotrienes\) released from mastocytes by the action of alcohol seems to be of principle significance. In the course of chronic alcohol consumption, in addition to lesions arising on acute intoxication, induction of an inflammatory reaction occurs in the form of mucosal inflammatory infiltrations particularly in the gastric antrum. The inflammatory process of the gastric mucosa has various activity and intensification and clinical signs. The recession of symptoms of acute poisoning or withdrawal syndrome does not stay in direct relation to the resolution or intensity of gastrointestinal tract disorders. The assessment of gastrointestinal injury in alcohol dependent patients is difficult due to the coincidence of different exogenic factors which cause gastric mucosal injury such as\: smoking, Helicobacter pylori infection, malnutrition, abuse of medication or the coincidence of other alcohol related organ injury, especially of the liver and pancreas. In these cases the connection of an etiological factor to a certain micro and macroscopic feature found in the gastric mucosa and to the clinical state in extremely difficult. The facts mentioned above were the direct cause of attempting to find an answer to whether such varied clinical findings of acute alcohol intoxication and withdrawal syndrome can be reflected in endoscopic and histologic findings in the gastric mucosa of alcohol dependent patients. The additional aim of this study was the examination of the dynamics of gastric mucosa lesions following controlled alcohol abstinence and the procurement of data based on analysis of endoscopic and histologic findings of gastric mucosa adaptation to chronic stress of alcohol abuse. This study involved 66 alcohol dependent patients hospitalised in the Department of Toxicology CMUJ who were divided into two groups\: one group of 28 patients admitted due to acute alcohol intoxication and another group of 38 patients admitted with variously intensified withdrawal syndrome. In each group following history taking and physical examination the indications for endoscopy within the first 24 hours post admission to the department were established. During gastrofiberoscopy biopsy specimens from the corpus, antrum and pylorus were collected for histological examination and for ureaze test to confirm or exclude Helicobacter pylori infection. Macro and microscopic findings were classified according to the actualised Sydney System. In 46 patients \(26 with withdrawal syndrome and 20 with acute alcohol poisoning\) in which, despite controlled abstinence, clinical sings concerning the gastrointestinal tract were still present, control gastrofiberoscopy was performed after 14 days with the aforementioned tests. The following features were characterised in both groups\: age, period of alcohol dependence, alcohol blood level, withdrawal syndrome intensity according to CIWA scale, presence of gastrointestinal signs, incidence of Helicobacter pylori infection and incidence of smoking. The presence of micro and macroscopic gastric mucosa lesions and their topography and level of injury was studied according to group dependence. Next the differences in gastric mucosa lesion degree according to topography, taking into account both time and group examined \(interaction assessment\) were analized. The influence of Helicobacter pylori infection and smoking on specific histological findings taking into account lesion topography and patient age were assessed."]

Number of results: 0