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Correlation of Endoscopic Findings with Various Helicobacter pylori Tests among Dyspeptic Patients  [PDF]
Mohammed O. Mohammed
International Journal of Clinical Medicine (IJCM) , 2014, DOI: 10.4236/ijcm.2014.519151
Abstract: Background: Helicobacter pylori is the most common chronic bacterial infection, and a significant etiological factor in acid peptic diseases and gastric cancer. Dyspepsia is a common gastrointestinal disorder, and the most common indication for gastroscopy. Detection of H. pylori during endoscopy has become standard clinical practice. Elevated levels of inflammatory markers such as C-reactive protein (CRP), are associated with pathological changes, and hence give useful information for exact diagnosis and therapy. Objectives: To determine the relationship between endoscopic findings, highly sensitive C-reactive protein level (hs-CRP) and H. pylori infection among dyspeptic patients using serological tests, stool antigen for H. pylori and antral histology. Methods: This was a prospective study; patients with dyspepsia, who referred to Kurdistan Teaching Center of Gastroenterology & Hepatology in Sulaimani City were assessed, during the period of December 2012 to March 2014. They underwent gastroscopy, and biopsies were taken from the corpus and antral portions of antral portion for histopathological exam. Patients’ serum samples were tested for H. pylori infection using ELISA method to detect (IgG & IgA) anti-bodies and stool samples were examined using rapid immunoassay method to detect H. pylori antigens. hs-CRP was assessed using ELISA. Results: One hundred dyspeptic patients were included in the study. The mean age was 34.2 years and male comprised 54% of the study samples. The common findings in oesophagogastroduodenoscopy (OGD) examination were antral gastropathy (59%) and duodenal ulcer (21%). A statistically significant (P < 0.01) correlation was found between hs-CRP and H. pylori IgG and IgA levels (titer). There was a highly significant (P < 0.01) correlation between the level of H. pylori IgG and the endoscopic findings. The highest serum level of H. pylori IgG was found in duodenal ulcer and antral gastritis, (88.86 ± 42.0) and (70.05 ± 35.2) Au/ml, respectively. There was a highly significant correlation (P < 0.01) between endoscopic findings and H. pylori positive antral biopsy, in duodenal ulcer, antral gastritis and duodenitis was 100%, 94.9% and 75% respectively. Also duodenal ulcer and antral gastritis showed high mean and percentage but no significant differences in both H. pylori IgA and stool Antigen.
Helicobacter pylori in dyspeptic children and adults: endoscopic, bacteriologic and histologic correlations
Solari, Claude A.;Araruna, Roberta P. N.;Reis, Eliane M. F.;Hofer, Ernesto;Dias, Gra?a;Moraes, Glória;Basilio, Carlos A.;Rodriguez, Charisse M. S.;Luna, Luiz L.;
Memórias do Instituto Oswaldo Cruz , 1994, DOI: 10.1590/S0074-02761994000400014
Abstract: using different bacteriological (urease test, gram staining and culture) and histological (steiner staining and modified giemsa staining) techniques, we searched for the presence of helicobacter pylori in the gastric antrum of 200 dyspeptic brazilian patients (106 females and 94 males aged 19 days to 81 years). the presence of bacteria was then correlated with the endoscopic and histological findings. h. pylori was present in 59.5 of the population studied. in brazil, colonization occurs early, involving 37 of the dyspeptic population by 20 years of age. the presence of h. pylori in the gastric antrum was strongly associated with duodenal ulcer (p < 0.001) and a normal endoscopic examination did not exclude the possibility of colonization of the gastric antrum by h. pylori. the most sensitive test was the preformed urease test (89). we conclude that more than one diagnostic method should preferably be used for the detection of h. pylori and that the presence of h. pylori is closely correlated with active chronic gastritis (p < 0.001).
Endoscopic Findings and Helicobacter pylori in Children on Long-Term Hemodialysis  [PDF]
Fakhrossadat Mortazavi,Mandana Rafeey
Pakistan Journal of Biological Sciences , 2008,
Abstract: The aim of this study is to evaluate the prevalence of GI symptoms, endoscopic abnormalities, histologic gastritis and Helicobacter pylori infection in children with End Stage Renal Disease (ESRD) undergoing maintenance hemodialysis. Upper endoscopy and gastric biopsy were performed in 31 consecutive ESRD children from 2002-2007, before renal transplantation. H. pylori status was determined by urease test and histology. The mean age of patients was 11 ±3.3 years (4-16 year). The mean duration of dialysis was 12.4 ±11 months (1.5-54 months). Seventeen patients (54.8%) were symptomatic. Twenty patients (64.5%) had endoscopic abnormalities. Antral erythema, esophagitis, antral nodularity and diffuse gastritis were common endoscopic findings. Endoscopic abnormalities were more common in symptomatic patients than asymptomatic patients (p<0.05). Twenty patients (64.5%) were H. pylori positive. There was no statistical correlation between age, sex, serum creatinine level, presence of any symptoms and endoscopic abnormalities with H. pylori positivity. The mean duration of dialysis in H. pylori negative patients was significantly longer in comparison with H. pylori positive patients. High prevalence of eodoscopic abnormalities and H. pylori infection in both symptomatic and asymptomatic patients emphasize the necessity of upper GI evaluation in ESRD children before renal transplantation.
Endoscopic findings in children with Helicobacter pylori infection and abdominal tenderness
Zamani A,Bahremand Sh,Ojaghi Haghighi S M,Daneshjou K
Tehran University Medical Journal , 2008,
Abstract: Background: Helicobacter pylori (Hp) infection often occurs in childhood and adolescence, with the frequency increasing with age. Hp infection is associated with insufficient hygiene, overcrowding and low socioeconomic status. Although declining in developed countries, children in the developing countries continue to have a high prevalence of Hp infection. As the association of Hp infection with chronic abdominal pain is not ubiquitously accepted, in this study we investigate the significance of endoscopic finding associated with Hp infection in children with abdominal tenderness.Methods: This cross-sectional study included 1,665 healthy children, aged 6 to 12 years, in whom Hp infection was evaluated using the IgG anti-H. pylori test. Hp-positive children with epigastric tenderness underwent upper gastrointestinal (GI) endoscopy. Urease activity of gastric mucosal biopsies was measured. The presence and density of Hp organisms, the presence of follicular gastritis, and the nature of inflammation and gastritis activity were assessed by histologic examination.Results: Of 1665 children, 429 (26%) subjects (51% girls, 49% boys) were seropositive for H. pylori. There was a significant association between Hp infection and older age (p<0.001) and male/female ratio (p<0.05). Epigastric tenderness was detected in 39 children (1%), 29 of whom underwent upper GI endoscopy. Nodular gastritis with antral erythema was the most common endoscopic finding (26/29; 89.7%). Histological findings revealed that, in all cases with endoscopic nodularity, lymphoid follicles were present. Bacterial density was low in 13 (44.8%), moderate in 14 (48.2%) and high in 2 (7%) subjects.Conclusion: The findings of the present study demonstrated that antral nodularity is the most common feature in children with Hp infection and epigastric tenderness was significantly associated with histological findings of lymphoid follicles.
Helicobacter pylori numa popula o dispéptica no Algarve: prevalência e caracteriza o genética Helicobacter pylori prevalence and genetic characterization in a group of dyspeptic patients from Algarve  [cached]
Hermano Santos,Horácio Guerreiro,Diamantino Sousa,José Estevens
Jornal Português de Gastrenterologia , 2010,
Abstract: INTRODU O: Dado o papel nuclear do Helicobacter pylori (Hp) na etiopatogenia das doen as gastroduodenais, é fundamental conhecer a sua prevalência e as suas características em cada regi o. OBJECTIVOS: determinar, numa popula o dispéptica no Algarve, a prevalência da infec o por Hp, fazer a sua caracteriza o genética e correlacionar ambas com os diagnósticos endoscópicos. MéTODOS: Seleccionamos, aleatoriamente, 205 doentes dispépticos submetidos a endoscopia digestiva alta. Para detec o de Hp utilizámos teste rápido da urease, exame cultural e exame histológico, admitindo-se infec o quando pelo menos dois testes foram positivos. Usámos a técnica de PCR para caracterizar os genes cagA, vacA, oipA e babA em 22 das estirpes isoladas. Estatística: testes χ2 e exacto de Fisher; IC - 95%. RESULTADOS: prevalência 44,9% (superior no sexo masculino e entre os 30 e os 59 anos); genes cagA + em 90,9%, oipA funcional em 78,9%, babA + em 50% e genótipo s1m1 em 31,8% das estirpes. Associa o da infec o apenas com úlcera duodenal. CONCLUS ES: 1) Prevalência da infec o de 44,9%, decrescente após os 60 anos. 2) Associa o da infec o apenas com úlcera duodenal. 3) Estirpes cagA + e oipA ON em propor o superior à esperada num país ocidental. INTRODUCTION: The role of Helicobacter pylori (Hp) in the ethiology of several gastroduodenal diseases is well established; it is thus important to know its prevalence and characteristics in different geographical zones. AIMS: to evaluate the prevalence of Hp infection in a dyspeptic population, to identify its genetic characteristics and correlate them with endoscopic findings. METHODS: 205 dyspeptic patients submitted to endoscopy were included. Helicobacter pylori presence was evaluated by rapid urease test as well as bacteriology tests and histopathology; infection was admitted when at least two tests were positive. We used PCR to characterize the genes cagA, vacA, oipA and babA in 22 of the isolated strains. Statistical: χ2 and exact Fisher’s tests; CI - 95%. RESULTS: prevalence: 44,9% (higher between 30 and 59 years old); genes cagA + in 90,9%, oipA functional in 78,9%, babA + in 50% and genotype s1m1 in 31,8% of the strains. Infection was only associated with duodenal ulcer. CONCLUSIONS: 1) Prevalence of the infection: 44,9 %, decreasing after 60 years of age. 2) Association of the infection only with duodenal ulcer. 3) rate of cag A + and oipA ON strains higher than expected in a western country.
Use of serum immunoglobulins G and A for detection of Helicobacter pylori infection in dyspeptic patients by enzyme immunosorbent assay  [cached]
Babay Hannan,Al Mofleh Ibrahim,Al Akwaa Ahmad,Al Humayed Suliman
Saudi Journal of Gastroenterology , 2000,
Abstract: Since the discovery of Helicobacter pylori (H. pylori), several invasive and non invasive tests have become available. The aim of this study was to test the performance of immunoglobulins IgG and IgA by using an enzyme linked immunosorbent assay (ELISA) test (In vitro diagnostika GmbH, Germany) for the diagnosis of H. pylori among dyspeptic patients. Blood samples from 152 dyspeptic patients and 51 asymptomatic controls were analyzed in a case control study. IgG and IgA were positive in 33.5% and 41.1% respectively compared to 13.8% for both IgG and IgA in controls (P=0.002). We support the future use of serology as a non invasive, and rapid test for the diagnosis of H. pylori infection among dyspeptic patients in areas with low prevalence. Endoscopy remains the method of choice for elderly dyspeptic patients and for those with possible gastric or duodenal pathology.
Helicobacter pylori numa popula??o dispéptica no Algarve: prevalência e caracteriza??o genética
Santos,Hermano; Guerreiro,Horácio; Sousa,Diamantino; Estevens,José; Gon?alves,Ana Prurito; Carvalho,Ana Paula; Inácio,Cristina; Faleiro,Maria Leonor; Dionísio,Lídia;
Jornal Português de Gastrenterologia , 2010,
Abstract: introduction: the role of helicobacter pylori (hp) in the ethiology of several gastroduodenal diseases is well established; it is thus important to know its prevalence and characteristics in different geographical zones. aims: to evaluate the prevalence of hp infection in a dyspeptic population, to identify its genetic characteristics and correlate them with endoscopic findings. methods: 205 dyspeptic patients submitted to endoscopy were included. helicobacter pylori presence was evaluated by rapid urease test as well as bacteriology tests and histopathology; infection was admitted when at least two tests were positive. we used pcr to characterize the genes caga, vaca, oipa and baba in 22 of the isolated strains. statistical: χ2 and exact fisher?s tests; ci - 95%. results: prevalence: 44,9% (higher between 30 and 59 years old); genes caga + in 90,9%, oipa functional in 78,9%, baba + in 50% and genotype s1m1 in 31,8% of the strains. infection was only associated with duodenal ulcer. conclusions: 1) prevalence of the infection: 44,9 %, decreasing after 60 years of age. 2) association of the infection only with duodenal ulcer. 3) rate of cag a + and oipa on strains higher than expected in a western country.
Concomitant Colonization of Helicobacter pylori in Dental Plaque and Gastric Biopsy  [PDF]
Amin Talebi Bezmin Abadi,Ashraf Mohabati Mobarez,Omid Teymournejad,Mona Karbalaei
Journal of Pathogens , 2014, DOI: 10.1155/2014/871601
Abstract: Frequently reported H. pylori antimicrobial therapy failures suggest that there might be a different niche where the bacteria can stay safe. Current study aims to examine potential role of oral colonization of H. pylori to feed reinfection after primary therapy. However, patients who were admitted to the gastroscopy section were chosen and gastric biopsy and dental plaque specimens were collected. Molecular and biochemical tests were applied to confirm H. pylori identity in different colonization niches. Results showed that 88.8% of dyspeptic patients had epigastric pains with nocturnal awakening when they were hungry ( ). All patients who received therapy already were again H. pylori positive while they are still carrying H. pylori in dental plaque ( ). Moreover, H. pylori infection was sought in 100% of gastric biopsy’s dyspeptic patients who had ulcerated esophagitis and erosive duodenitis and who were H. pylori positive, and 75% of dyspeptic patients with duodenum deformity had this bacterium in gastric biopsies ( ). Present study showed that only successful eradication of gastric H. pylori cannot guarantee prevention of reinfection. Conclusively, a new strategy which indicates concomitant eradication in oral and gastric colonization can result in clearance of H. pylori infection. 1. Introduction Helicobacter pylori (H. pylori) is a Gram-negative, spiral, and motile bacterium that is present in the human stomach of approximately half of the world’s population [1]. H. pylori is an important gastrointestinal pathogen that is strongly associated with gastritis as well as peptic ulcer disease. There is strong evidence that H. pylori has an undeniable role in occurrence of gastric abnormality, atrophic inflammation, and gastric cancer [2]. Colonization begins in childhood; however, little is known about its timing and actual route of bacterial transmission [3, 4]. Recent findings are indicating a narrow link between oral and gastric colonization of H. pylori [5]. Frequently failed antibiotic therapy to cure H. pylori infection suggests that there might be certain different sites where the organism can survive [1, 6]. To date, the exact mechanism of transmission of H. pylori is not fully understood, a crucial fact which implies on unknown routes and reservoir locations that are still undiscovered. Indeed, defeated therapeutic approaches to cure gastric H. pylori infection triggered a thought that different locality might be involved in reinfection of this persistent bacterium [6]. Nonetheless, alarm symptoms and endoscopic finding are such approach to
Prevalence of Helicobacter pylori infection in dyspeptic patients in Iran  [cached]
Leila Shokrzadeh,Kaveh Baghaei,Yoshio Yamaoka,Seiji Shiota
Gastroenterology Insights , 2012, DOI: 10.4081/gi.2012.e8
Abstract: Although Helicobacter pylori (H. pylori) infection has been known to be associated with several upper gastrointestinal disorders such as peptic ulcer and gastric cancer, the relationship between H. pylori infection and dyspeptic symptoms remains controversial. Furthermore, it is still not clear which factors are associated with H. pylori infection in the Iranian population. We investigated the prevalence of H. pylori infection in dyspeptic patients and factors associated with H. pylori infection in the Iranian population. In this cross-sectional study, 303 patients with dyspeptic symptoms underwent endoscopy. Clinical data and a questionnaire about gastrointestinal symptoms were collected from each patient. H. pylori status was evaluated by histological examination. Among the 303 patients, 263 (86.8%) were found to be positive for H. pylori. The prevalence of H. pylori infection decreased significantly with age. There was no difference in the prevalence of H. pylori infection between the patients with and those without a family history of gastroduodenal diseases. Among 250 patients with abdominal pain, 219 (87.6%) were infected with H. pylori. Among 211 patients with epigastric abdominal pain, 185 (87.7%) were infected with H. pylori. It was observed that belching was significantly associated with H. pylori infection (P = 0.03). Dyspepsia triggered by the consumption of tea was higher in H. pylori-positive patients than in H. pylori-negative patients (P = 0.03). The prevalence of H. pylori infection in dyspeptic patients was quite high in Iran. Belching and dyspepsia triggered by tea consumption was related with H. pylori infection.
Prevalence of Helicobacter pylori among Nigerian patients with dyspepsia in Ibadan
AC Jemilohun, JA Otegbayo, SO Ola, OA Oluwasola, A Akere
Pan African Medical Journal , 2010,
Abstract: Introduction: Determination of the true prevalence of Helicobacter pylori (H. pylori) is difficult in a hyper-endemic area like Nigeria with use of serological tests because of their low discriminatory power between previous and current infections. The use of biopsy based methods will go a long way to mitigate this problem. We investigated the prevalence of H. pylori in dyspeptic patients and its relationship with gastroduodenal pathologies using gastric biopsy histology and rapid urease test. Methods: Eighty-six consecutive adult patients with dyspepsia underwent upper gastrointestinal endoscopy using forward-viewing endoscopes. Antral biopsy specimens were collected for histology and rapid urease test. Diagnosis of H. pylori infection was made if both or either of the tests was positive. Results: Of the 86 subjects, there were 39 (45.3%) males and 47(54.7%) females. The age range was 23 to 85 years with a mean of 49.19±13.75 years. Diagnosis of H. pylori was made in 55(64%) patients. Gastritis was the commonest endoscopic finding (60.5%), serious gastroduodenal pathology (gastric ulcer, duodenal ulcer and gastric cancer) were documented in only 12 (14%) patients. Thirty three (63.5%) of the 55 patients with gastritis had H. pylori infection while 7(58.3%) of the 12 patients with serious gastroduodenal lesions had the infection. Thirteen (72.2%) of the 18 patients that had normal endoscopic findings were H.pylori positive. Conclusion: The prevalence of H. pylori among dyspeptics using biopsy based methods is high in the South-Western part of Nigeria. It is therefore important to test and treat H. pylori among Nigerians with dyspepsia.
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