Abstract
Background: Infection with Helicobacter pylori (H. pylori) is a recognized cause of peptic ulcer and gastritis. Persistence of infection is a definite risk factor for gastric malignancy. Healing of gastritis after eradication of H. pylori reduces the risks of peptic ulcer disease and gastric malignancy. Objectives: To find out the relationship of H. pylori with erosive and nonerosive gastritis, the effect of anti-H. pylori therapy and to compare the effects of anti-H. pylori therapy between two types of gastritis. Materials and Methods: This prospective study was done in the Gastroenterology department of Bangabandhu Sheikh Mujib Medical University, Dhaka from June 2008 to May 2009. One hundred eighty dyspeptic patients were enrolled for the study. Patients with gastritis diagnosed by endoscopy underwent rapid urease test (RUT). RUT positive patients were considered to have H. pylori infection and were treated with triple therapy (omeprazole, amoxycillin and metronidiazole) for 14 days. Treatment responses were assessed by clinical history and also by endoscopic biopsy and RUT. Results of endoscopic findings and RUT after treatment were compared with pretreatment status. Results: Seventy patients completed the treatment and finally could be assessed. Endoscopic findings of 70 patients revealed that 56 (80%) patients had erosive gastritis and 14 (20%) patients had nonerosive gastritis. After treatment, 47 (67.1%) lesions became normal, 16 (22.9%) remained erosive and 7 (10%) non-erosive as before. Out of 14 non-erosive diseases, 7 became normal, while out of 56 erosive diseases 40 became normal. The erosive group responded significantly better than the non-erosive group (c2=32.766, p<0.001). Fifty nine (84.3%) patients with gastritis showed negative urease test after treatment. Conclusion: Strong relation between H. pylori infection and gastritis was found. Majority were antral erosive gastritis. Erosive group responded better than non-erosive group. DOI: http://dx.doi.org/10.3329/jemc.v4i1.18063 J Enam Med Col 2014; 4(1): 15-20
Highlights
Peptic ulcer disease and chronic gastritis are common disorders
H. pylori infection is largely restricted to the gastric antrum
Studies showed that H. pylori occurs in the antrum in at least 85% of patients with the disease, and in up to 15% of patients the organism is found only in the corpus.[11,12]
Summary
Association between chronic gastritis and active duodenal ulcer is 100% compared to 50% in non-ulcer controls.[1] About 75% of patients with chronic gastritis have been found to have H. pylori infection compared to 10% in those without. The overall prevalence of H. pylori infection is 28.7% in superficial gastritis, 57% in erosive gastritis, 63% in gastric erosion, 80% in gastric ulcer and 52.4% in early gastric cancer.[2] The number of antral H. pylori organisms is associated with severity of chronic gastritis.[3,4]. Infection with Helicobacter pylori (H. pylori) is a recognized cause of peptic ulcer and gastritis. Healing of gastritis after eradication of H. pylori reduces the risks of peptic ulcer disease and gastric malignancy. Patients with gastritis diagnosed by endoscopy underwent rapid urease test (RUT). Results of endoscopic findings and RUT after treatment were compared with pretreatment status. Fifty nine (84.3%) patients with gastritis showed negative urease test after treatment.
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