Abstract
Symptom resolution is the most common clinical practice during assessment and evaluation of helicobacter pylori infected patients after employing eradication therapy. Prediction of eradication of H. pylori with symptom resolution and assess factors affecting symptom resolution. Facility based follow up study was done on consented H. pylori positive adult patients who received standard triple therapy consisting of a proton pump inhibitor, amoxicillin, and clarithromycin from May 2016 to April 2018 at Bahir Dar city in Ethiopia. Sociodemographic and clinical data was collected before and after eradication therapy by using pre-developed structured questionnaire. Both positive and negative predictive values were calculated. SPSS version 23 was used to conduct bivariate and backward stepwise multivariate logistic regression to analyze data. P-value < 0.05 at 95%CI was considered as significant. The study involved a total of 421 patients who completed follow up. Patients' mean age and body weight (±SD) were 30.63 (± 10.74) years and 56.71 (± 10.19) kg, respectively. Complete symptom resolution was achieved in 84.3% of the patients and eradication of H. pylori was successful in 90% of patients. Positive predictive value of complete symptom resolution for H. pylori eradication was 98.9% (351/355) and whereas negative predictive value was 57.6%(38/66). Factors associated with complete symptom resolution were regimen completion (AOR: 2.77 95%CI (1.12-6.86), p = 0.028) and no use of traditional homemade supplements prepared from Fenugreek or Flaxseed (AOR: 2.09 95%CI (1.22-3.58), p = 0.007). Complete symptom resolution is a powerful predictor of success of H. pylori eradication and can be used to assess H. pylori status after eradication therapy. Assessment of complete symptom resolution should consider regimen completion and traditional practice of using homemade supplements prepared from Fenugreek or Flaxseed.
Highlights
Helicobacter pylori (H. pylori) infection has been reported to affect half to two third of the world’s population
Complete symptom resolution is a powerful predictor of success of H. pylori eradication and can be used to assess H. pylori status after eradication therapy
The most commonly recommended initial H. pylori eradicate therapy approved in many guidelines is standard triple therapy regimen which consists of a proton pump inhibitor (PPI) and two antibiotics, commonly clarithromycin, and amoxicillin usually prescribed for 10 to 14 days [16,17,18,19]
Summary
Helicobacter pylori (H. pylori) infection has been reported to affect half to two third of the world’s population. Higher prevalence of H. pylori infection has been reported from developing countries, its prevalence shows geographical variability in both developed and developing countries [1,2,3]. Development of various upper gastrointestinal tract disorders including gastroduodenal ulcer disease, chronic gastritis, and gastric mucosa-associated lymphoid tissue lymphoma, and gastric cancer has been associated with H. pylori infection [5,6,7]. Upper gastrointestinal dyspepsia symptoms originated from H. pylori infection has been classified as non-functional organic disorders [8] to differentiate it from functional dyspepsia which shows symptom persistence or recurrence after eradication [9]. Symptom resolution is the most common clinical practice during assessment and evaluation of helicobacter pylori infected patients after employing eradication therapy
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