Histological modifications of gastric mucosa and functional correlations in rheumatoid arthritis

Twenty-seven patients with rheumatoid arthritis were studied in order to demonstrate possible correlations between gastric mucosal changes, gastric acid secretion, serum gastrin, and long-term anti-inflammatory therapy. Severe chronic atrophic gastritis associated with impaired maximal acid output was observed in ten cases (37%); in six of these fasting hypergastrinemia and in seven impaired baseline acid output were also present. Chronic atrophic gastritis and hypochlorhydria were present in two of the three untreated patients studied, and in one of these hypergastrinemia was also associated. These results show the high frequency of chronic atrophic gastritis and its related functional alterations in rheumatoid arthritis. The presence of chronic atrophic gastritis, even in untreated patients, would point to the lesion being a part of the systemic disease and not simply resulting from long-term anti-inflammatory therapy.