Correlation of Helicobacter pylori infections in patients of dyspepsia with or without ulcer with endoscopic findings

Abstract

Introduction: Since the discovery of H. pylori in 1983, the diagnosis and treatment of upper gastrointestinal diseases have changed greatly. A higher risk of the development of gastric cancer has been reported in subjects with positive serologic tests for H. pylori. Aims: Isolation of Helicobacter pylori from dyspeptic patient with or without ulcer and its correlation with endoscopic findings. Settings and Design: Prospective cross sectional study. Methods and Material: The study was conducted in the Department of Microbiology, SMIMS, Tadong, Gangtok for a period of 1 year (01.05.2013 – 30.04.2014) with patients with symptoms of dyspepsia. The parameters of investigation included upper gastrointestinal endoscopy, rapid urease test, Gram smear examination and isolation & identification of H. pylori by cultural technique. Results: Out of 50 patients, 32(64%) were positive for H. pylori by any of the three parameters. Of these, 26 (52%) were positive by RUT, 16(32%) by direct Gram stained smears, and 9(18%) by culture. Out of 50 samples, 9 (18%) were positive by both RUT and direct Gram smear microscopy, 7 (14%) by both RUT and culture, 9 (18%) by both direct Gram smear microscopy and culture and 7 (14%) by all the three methods. Discussion: The results revealed that the RUT should not be a sole criterion for diagnosis of dyspepsia associated by H. pylori. Culture is probably the most difficult approach to the diagnosis of H. pylori, however, it is considered as gold standard, highly specific and also antibiotic sensitivity can be detected. Conclusions: Among the endoscopic findings, esophagitis cases revealed 100% positive result by all the three parameters, while duodenitis, antroduodenitis and antral gastritis showed, 57%, 50% and 38.4% positive result by any of the three parameters. Considering our results it reveals that there is much correlation between esophagitis and H. pylori infection.