Prevalence of Helicobacter pylori Infection in Peptic Ulcers: Experience in an Urban Community Setting

Abstract

Purpose: To determine the prevalence of H. pylori infection in patients diagnosed with peptic ulcer disease in two urban community hospitals from 2006 to 2010. Methods: This was a retrospective study of all patients diagnosed with peptic ulcer disease by upper endoscopy in two urban community hospitals from 2006 to 2010. The patients simultaneously received testing for H. pylori via rapid urease testing or histopathology. A chi-square or Fisher's exact test was used to detect the difference between groups. Results: A total of 686 ulcers (455 gastric, 231 duodenal) were identified endoscopically and tested for H. pylori. Results of testing were available for 429 gastric ulcers and 221 duodenal ulcers (total = 650). Rapid urease testing was used to detect H. pylori in 48% of gastric ulcers and 44% of duodenal ulcers. The remainder had histopathologic testing. 20.3% of gastric ulcers (95% CI = 16.5%-24.1%) and 32.6% of duodenal ulcers (95% CI = 26.4 %-38.8%) were positive for H. pylori (p<0.001). The rates of H. pylori in peptic ulcer disease did not vary considerably between African Americans and Caucasians (13.9% vs. 11.4%, p=0.373) or between inpatients and outpatients (22% vs. 24%, p=0.617). H. pylori infection rate was greater in males diagnosed with PUD compared to females (28.8% vs. 24.5%, p=0.016). Conclusion:H. pylori infection continues to be a significant cause of PUD in both Caucasians and African Americans in the urban community setting. However, this study shows that rates of H. pylori infection contributing to PUD from 2006 to 2010 is significantly lower than that previously reported. This may be due to multiple reasons, including widespread use of antibiotics and acid-suppressing agents. Future studies should continue to address H. pylori infection in GI diseases, including PUD, dyspepsia, and GERD, as treatment options may depend on prevalence rates.Figure: [103]