To compare the difference between primary bile reflux gastritis (BRG) and helicobacter pylori (HP) infection associated gastritis and explore the risk factors of primary BRG.

168 patients with chronic gastritis in Ningxia people's hospital from January 2017 to January 2018 were enrolled. The subjects were divided into two groups according to the presence or absence of bile reflux and HP infection. In group A, 67 patients were diagnosed with endoscopic BRG with or without HP infection, while in group B, 101 patients were diagnosed with chronic gastritis with definite HP infection but without bile reflux. Demographic data, concomitant diseases, upper gastrointestinal involvement pattern and pathological features of the two groups were statistically analyzed.

The number of patients aged from 61 to 70 in group A was the highest, and the difference was statistically significant (P=0.033) compared with group B, while the overall age of patients in group 2 was not statistically significant (P>0.05). The ratio of male and female in group A was close to 1: 2, while that in group B was 2: 1, and the difference was statistically significant (P<0.05). The most common symptoms of gastritis in the two groups were upper abdominal pain or discomfort (71.64% in group A and 73.63% in group B), with no statistically significant difference (P=0.871). The second most common symptom in group A was acid regurgitation and heartburn (40.29%), with statistically significant differences (P=0.000). The detection rates of diabetes, hypertension and cholecystectomy in group A were significantly higher than those in group B. Underweight was more common in group A patients, and overweight was more common in group B patients, but there was no significant difference in BMI between the two groups (P=0.097). The detection rate of reflux esophagitis in group A was significantly higher than that in group B, and the difference was statistically significant (P=0.028). For ulcerative diseases (gastric ulcer, duodenal ulcer), the detection rate was higher in group B, with statistical significance (P=0.001). Histopathology showed that the atrophy of metaplasia was more common in group A, while the atrophy of non-metaplasia was more common in group B, but the difference was not statistically significant.

There are similarities between primary BRG and HP infection-related gastritis, but there are differences in age of onset, clinical manifestations, complications and pathologic manifestations. Women with reflux esophagitis, diabetes and a history of cholecystectomy were found to be associated with primary BRG.