Histopathological Spectrum of Gastric Biopsies in Patients with Chronic Dyspepsia: A Cross-Sectional Observational Study.
DOI:
https://doi.org/10.51168/sjhrafrica.v6i9.2180Keywords:
Chronic dyspepsia, Gastric biopsy, Histopathology, Helicobacter pylori, GastritisAbstract
Background:
Chronic dyspepsia remains one of the most common gastrointestinal complaints, with etiologies ranging from benign inflammatory changes to premalignant and malignant conditions.
Objectives:
To determine the histopathological spectrum of gastric mucosal lesions in patients presenting with chronic dyspepsia and to evaluate the correlation of H. pylori infection with histopathological patterns.
Methods:
This cross-sectional observational study was conducted on 50 patients with chronic dyspepsia who underwent upper gastrointestinal endoscopy at a tertiary care hospital. Gastric biopsies were obtained primarily from the antrum and processed for histopathological examination using hematoxylin and eosin staining. Modified Giemsa stain was used for the detection of H. pylori. Data were analyzed using descriptive statistics and chi-square test, with p < 0.05 considered significant.
Results:
The mean age of the study population was 44.6 ± 12.4 years, with a male-to-female ratio of 1.3:1. The antrum was the predominant site of biopsy (68%). Chronic non-specific gastritis (44%) was the most common histological finding, followed by chronic active gastritis (22%), reactive (chemical) gastropathy (6%), atrophic gastritis (4%), intestinal metaplasia (4%), and gastric adenocarcinoma (4%). Helicobacter pylori was detected in 28% of cases, showing a statistically significant association with chronic active and atrophic gastritis (χ² = 9.84; p = 0.021). Overall, inflammatory lesions constituted 78%, premalignant lesions accounted for 8%, and malignant lesions comprised 6% of the total biopsies.
Conclusion:
Chronic gastritis, predominantly involving the antrum, was the leading cause of dyspepsia. The significant association of H. pylori with chronic active and atrophic gastritis highlights its pivotal role in gastric mucosal injury and carcinogenic transformation.
Recommendations:
Routine gastric biopsies with H. pylori detection should be incorporated in all patients with persistent dyspepsia. Early eradication therapy, histological surveillance for atrophic or metaplastic changes, and lifestyle modifications may reduce progression to malignancy.
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Copyright (c) 2025 Dr. Mohammed Amer Rohaid, Dr. Seema Khan, Dr. Sindhu Gugulothu, Dr. Mohammed Mohiddin Ghouse

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