Abstract
Background: Helicobacter pylori (H pylori) related gastritis is a major health ailment in developing nations. There is high morbidity and mortality ranging from chronic gastritis to gastric malignancies. Prevalence of H pylori infection varies markedly from country to country and in a country, region to region. Aim of the study: To evaluate the commonly available diagnostic methods, Rapid Urease Test (RUT) and conventional histopathology in diagnosis of H pylori gastritis and analyse the association of H Pylori with the development of gastrointestinal complications. Settings and design: Cross sectional prospective study conducted during the period of May 2012 to September 2014. Material and method: The study was carried out in a tertiary medical college hospital in southern India. Patients presenting with dyspeptic symptoms were subjected to endoscopy and investigated for H pylori infection through histopathological examination and RUT of biopsy specimen. Diagnosis of H pylori was made if one or both diagnostic test results were positive. Results: Out of 530 patients analyzed, diagnosis of H pylori was made in 329 patients (62.0%). There were significant statistical correlations of presence of endoscopic abnormalities and serious gastrointestinal complication (peptic ulcer and dysplasia/cancer) with H pylori infection. RUT had comparable predictive values to histopathology in diagnosis of H Pylori infection. Conclusion: H Pylori is implicated with significant morbidity and mortality due to associated gastrointestinal complications. Early and precise detection by multiple cost-effective methods, bearing good patient compliance and prompt treatment is essential for prevention of serious complications.
Highlights
Chronic gastritis and gastric ulceration are prevalent in a high magnitude throughout the world [1]
Histopathological assessment of gastric mucosa was done by pathologist and grading was done for mononuclear cell infiltration, neutrophilic infiltration, atrophy, intestinal metaplasia and density of H pylori according to the visual analogue of updated Sydney grading system [9] of reporting gastric biopsies
Endoscopic abnormalities when compared with H pylori presence, yielded significant results, with 294 out of 329 H pylori positive cases revealing any of the abnormalities, with p value
Summary
Chronic gastritis and gastric ulceration are prevalent in a high magnitude throughout the world [1]. H pylori gastritis is the principal cause of chronic active gastritis and has major complications like gastric adenocarcinoma and mucosa associated lymphoid tissue lymphoma (MALT lymphoma) [2]. Aim of the study: To evaluate the commonly available diagnostic methods, Rapid Urease Test (RUT) and conventional histopathology in diagnosis of H pylori gastritis and analyse the association of H Pylori with the development of gastrointestinal complications. There were significant statistical correlations of presence of endoscopic abnormalities and serious gastrointestinal complication (peptic ulcer and dysplasia/cancer) with H pylori infection. RUT had comparable predictive values to histopathology in diagnosis of H Pylori infection. Conclusion: H Pylori is implicated with significant morbidity and mortality due to associated gastrointestinal complications. And precise detection by multiple cost-effective methods, bearing good patient compliance and prompt treatment is essential for prevention of serious complications
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