Abstract
Aims of the study: Helicobacter pylori (H. pylori) induces inflammatory changes in the gastric mucosa variably correlated to different endoscopic and histologic features. The present prospective study aimed to correlate different endoscopic findings with histomorphological changes and the presence of H. pylori in the gastro-duodenal mucosa, in samples of dyspeptic patients. Methods: 60 dyspeptic patients of 18 years to 60 years of age were selected from outpatient department and screened with gastro-duodenoscopy and biopsy. The presence of H. pylori was determined by urease test on fresh biopsy specimens and histologically using the modified Giemsa stain. Findings were recorded and analyzed statistically. Results: Highest (84.6%) H. pylori positivity was seen in the 41-50 years age group. Majority of the patients had a normal upper gastro-intestinal endoscopy; among them majority (61.2%) was positive for H. pylori infection. Most cases with endoscopic lesion in the gastro-duodenal mucosa were also positive for H. pylori infection. On biopsy, chronic gastritis was the most common (73.33%) finding in 44 cases, among them, more than two-third (70.4%) were positive for H. pylori. Conclusion: H. pylori gastritis is strongly associated with peptic ulcer diseases, chronic gastritis and non-ulcer dyspepsia. Endoscopy and biopsy play the main role in diagnosis and identification of the spectrum of involvement.
Highlights
Helicobacter pylori are a gram negative, flagellated, spiral organism that resides in the antral mucosa, in the interface between the surface gastric epithelial cells and the overlying mucous gel layer
Several studies have concluded that, eradication of H. pylori in ulcer patients leads to an eight-fold reduction in the rate of recurrence found with conventional anti-ulcer therapies [6,7]
The diagnosis of H. pylori infection is currently based upon endoscopic biopsy-based tests- rapid urease test, histopathology and non-invasive tests like- urea breath test, stool antigen test, ELISA and PCR [9]
Summary
Helicobacter pylori are a gram negative, flagellated, spiral organism that resides in the antral mucosa, in the interface between the surface gastric epithelial cells and the overlying mucous gel layer. It was first isolated from human gastric biopsy material in 1982 by Warren and Marshall in Australia [1]. H. pylori infection is found in more than 90% of duodenal ulcer patients and in around 75% of all peptic ulcer sufferers. The risk of gastric cancer has been estimated to be six-fold higher in H. pylori infected populations than in uninfected populations [8]. The advantage of histology is that, along with visualization of the organism, the spectrum of pathological changes associated with H. pylori likechronic gastritis, ulceration, erosion, atrophy, metaplasia or malignant change can be assessed [4]
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