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Helicobacter Pylori Infection among Dyspeptic Patients Referred for Endoscopy

    Authors

    1 Department of Medicine College of Medicine, University of Baghdad, Baghdad, Iraq.

    2 Department of Medicine, Baghdad Teaching Hospital Baghdad, Iraq.

,

Document Type : Research Paper

Abstract

BACKGROUND:
Functional dyspepsia is one of the most common gastrointestinal symptoms and attributed to various causes including Helicobacter pylori infection.
AIM OF THE STUDY:
To correlate Helicobacter pylori infection to functional dyspepsia and to identify the possible risk factors for this infection.
PATIENTS AND METHODS:
Fifty patients who were referred to the endoscopy unit for dyspepsia symptoms, secondary gastric causes of dyspepsia were excluded during endoscopy, gastric biopsies were taken for histopathological study and for bedside urease test for detection of Helicobacter pylori infection.
RESULTS:
62% of non-ulcer dyspeptic patients were infected with Helicobacter pylori, 74.2% of the patients were above 30 years old, female gender patients were more than male patients ( 61.3% versus 38.7%).Using two standard methods of diagnosis of Helicobacter pylori infection, 31 patients had positive histopathology and urease test, 9 of them were positive for helicobacter pylori infection  with single method (6 by histopathology and 3 by urease).Histopathology test has sensitivity 88% and specificity 76% in respect to rapid urease test for detection of Helicobacter pylori infection.
CONCLUSION:
The incidence of helicobacter pylori infection in patients with functional dyspepsia doesn’t differ from what reported in general population in our locality which may argue the role of helicobacter pylori infection in non-ulcer dyspepsia. Female gender and age >30 years were the common risk factors for the infection. Smoking and alcohol consumption were not associated with increased risk of infection.
 

Keywords

References
1.     William L. Hasler. Functional dyspepsia .Harrison's textbook of principles of internal medicine, McGraw Hill, USA; 19ed. 2015: 345
2.     Carmona-Sanchez R. funcional gastroparesia. RevGastroenterol Mex. 2015; 80 Supl 1:26-8.
3.     Ford AC, Omayyad P. Current guidelines for dyspepsia management. Dig Dis. 2008; 26:225-30.
4.     Dizdar V, Gilja OH, Hausken T. Increased visceral sensitivity in Giardia-induced post infectious irritable bowel syndrome and functional dyspepsia.  Neurogastroenterol Motil. 2007; 19:977–82.
5.     Stephen Hans Berger, Parit Mekaroonkamol, Behtash Ghazi. H. pylori infection.Sleisenger & Fordtran's Gastrointestinal and Liver Disease 10thed. 2016: 198-202.
6.     Mette Wildner, Jane M. Hasen. Rates of Dyspepsia One Year after Helicobacter pylori Screening and Eradication in a Danish Population. GASTROENTEROLOGY 2003; 125:372–79.
7.     Ernst J. kuipers. Functional disorders of the gastrointestinal tract. Goldman-Cecil Medicine 25th edition, 2015: chapter 139: 909
8.     Hanevik K, Hausken T, Morken MH, et al. Persisting symptoms and duodenal inflammation related to Giardia infection. J Infect. 2007; 55:524–30
9.     Liu Y, Vosmaer GD, Tytgat GN, et al. Gastrin (G) cells and somatostatin cells in patients with dyspeptic symptoms: Helicobacter pylori associated and non-associated gastritis. J Clin Pathol. 2005; 58:927-31.
10.Konturek SJ, Brzozowski T, Konturek PC, et al. Brain-gut and appetite regulating hormones in the control of gastric secretion and mucosal protection. J Physiol Pharmacol. 2008; 59 Suppl 2:7–31
11.Lee Goldman .Goldman-Cecil textbook of Medicine 25th 2015, chapter 132:864
12.Suzuki, H. & Omayyad, P. Nat. Rev. Gastroenterol. Hepatol. 10, 2013: 168–174
13.Suzuki, S. et al. Delayed gastric emptying and disruption of the interstitial cells of Cajal network after gastric ischaemia and reperfusion. Neurogastroenterol. Motil. 22, 585–593 (2010).
14.Mogami, S. Reduced ghrelin production induced anorexia after rat gastric ischemia and reperfusion. Am. J. Physiol. Gastrointest. Liver Physiol. 2012:  359–64.
15.Athertan, Martin J. Blaser. H. pylori infection. Harrison's principles of internal medicine 19ed 2015, chapter 188, 1038-40.
16.R.H. Hunt, S.D. Xiao, F. Megraud, et al. Helicobacter pylori in developing countries. J Clin Gastroenterol 2011; 45: 383–88.
17.F Bazzoli, L De Luca, P Pozzato et al .Helicobacter pylori and functional dyspepsia: review of previous studies and commentary on new data Gut 2002; 50(Suppl IV):iv33–iv35.
18.Kassir ZA, Abdullah AA. 1994: helicobacter pylori in various gastrointestinal diseases. J Fac Med Baghdad 36:341-9.
19.Al-Hadithi TM and Naji NR.: the significance of Helicobacter pylori infection in non-ulcer dyspepsia. The Iraqi J Med Sci 2000; 1:18-21.
20.Haitham I. Baqir, Assam M. Abdullah, Anton S. Al-bana et al. sero-prevalence of helicobacter pylori infection in unselected adult population in Iraq. IJGE 2002;1 :25-28.
21.Mohammad A. Sheikhani, Taha A. Alkarbuly, Pshko T. M. Helicobacter Pylori infection among Dyspeptic Patients Referred for endoscopy.  Zanco J Med Sci, 2010:14, 37-43.
22.Nibras S. Al-Ammar1, Saad S. Hamadi, et al. Demographical Study of H. pylori Associated Gastritis. International Research Journal of Microbiology 2011;2 :056-62.
23.Chariya Chomvarin a, Wises Namwat a, Kunyaluk Ch.et al .Prevalence of Helicobacter pylori vacA, cagA, cagE, iceA and babA2 genotypes in Thai dyspeptic patients.Int J Infect Dis. 2008; 12:30-6.
24.Muhammad K. Hassan, Moeen-ul Haq, Naimatullah Khan.The frequency of H. pylori infection in patient with functional dyspepsia.Gomal Journal of Medical Sciences 2013, Vol. 11:183-86.
25.Patchett S, Beattie S, Leen E, et al. Eradicating Helicobacter pylori and symptoms of non-ulcer dyspepsia. Br Med J 1991; 303:1238-40.
26.Salankar HV, Rode SB, Hemnani TJ.  Sociodemographic profile of Helicobacter pylori positive functional dyspepsia patients in central India. Int J Basic Clin Pharmacol 2015; 4:483-87.
27.J.L. Rodríguez-Garcíaa, R. Carmona-Sánchez. Functional dyspepsia and dyspepsia associated with Helicobacter pylori infection: Do they have different clinical characteristics?Rev Gastroenterol Mex. 2016; 81:126-33.  
28.Ching Chu LO. Comparison of clinical, serological and histological findings between non-ulcer dyspepsia with and without helicobacter pylori infection. Journal of Gastroenterology and Hepatology 2001; 16:276-81. 
29.G. maconi.Is routine histological evaluation an accurate test for helicobacter pylori infection? AlimentPharmacolTher1999;13:327-31.
 
 
1.     William L. Hasler. Functional dyspepsia .Harrison's textbook of principles of internal medicine, McGraw Hill, USA; 19ed. 2015: 345
2.     Carmona-Sanchez R. funcional gastroparesia. RevGastroenterol Mex. 2015; 80 Supl 1:26-8.
3.     Ford AC, Omayyad P. Current guidelines for dyspepsia management. Dig Dis. 2008; 26:225-30.
4.     Dizdar V, Gilja OH, Hausken T. Increased visceral sensitivity in Giardia-induced post infectious irritable bowel syndrome and functional dyspepsia.  Neurogastroenterol Motil. 2007; 19:977–82.
 
 
 
5.     Stephen Hans Berger, Parit Mekaroonkamol, Behtash Ghazi. H. pylori infection.Sleisenger & Fordtran's Gastrointestinal and Liver Disease 10thed. 2016: 198-202.
6.     Mette Wildner, Jane M. Hasen. Rates of Dyspepsia One Year after Helicobacter pylori Screening and Eradication in a Danish Population. GASTROENTEROLOGY 2003; 125:372–79.
7.     Ernst J. kuipers. Functional disorders of the gastrointestinal tract. Goldman-Cecil Medicine 25th edition, 2015: chapter 139: 909
8.     Hanevik K, Hausken T, Morken MH, et al. Persisting symptoms and duodenal inflammation related to Giardia infection. J Infect. 2007; 55:524–30
9.     Liu Y, Vosmaer GD, Tytgat GN, et al. Gastrin (G) cells and somatostatin cells in patients with dyspeptic symptoms: Helicobacter pylori associated and non-associated gastritis. J Clin Pathol. 2005; 58:927-31.
10.Konturek SJ, Brzozowski T, Konturek PC, et al. Brain-gut and appetite regulating hormones in the control of gastric secretion and mucosal protection. J Physiol Pharmacol. 2008; 59 Suppl 2:7–31
11.Lee Goldman .Goldman-Cecil textbook of Medicine 25th 2015, chapter 132:864
12.Suzuki, H. & Omayyad, P. Nat. Rev. Gastroenterol. Hepatol. 10, 2013: 168–174
13.Suzuki, S. et al. Delayed gastric emptying and disruption of the interstitial cells of Cajal network after gastric ischaemia and reperfusion. Neurogastroenterol. Motil. 22, 585–593 (2010).
14.Mogami, S. Reduced ghrelin production induced anorexia after rat gastric ischemia and reperfusion. Am. J. Physiol. Gastrointest. Liver Physiol. 2012:  359–64.
15.Athertan, Martin J. Blaser. H. pylori infection. Harrison's principles of internal medicine 19ed 2015, chapter 188, 1038-40.
16.R.H. Hunt, S.D. Xiao, F. Megraud, et al. Helicobacter pylori in developing countries. J Clin Gastroenterol 2011; 45: 383–88.
17.F Bazzoli, L De Luca, P Pozzato et al .Helicobacter pylori and functional dyspepsia: review of previous studies and commentary on new data Gut 2002; 50(Suppl IV):iv33–iv35.
18.Kassir ZA, Abdullah AA. 1994: helicobacter pylori in various gastrointestinal diseases. J Fac Med Baghdad 36:341-9.
19.Al-Hadithi TM and Naji NR.: the significance of Helicobacter pylori infection in non-ulcer dyspepsia. The Iraqi J Med Sci 2000; 1:18-21.
 
453
 
 
 
20.Haitham I. Baqir, Assam M. Abdullah, Anton S. Al-bana et al. sero-prevalence of helicobacter pylori infection in unselected adult population in Iraq. IJGE 2002;1 :25-28.
21.Mohammad A. Sheikhani, Taha A. Alkarbuly, Pshko T. M. Helicobacter Pylori infection among Dyspeptic Patients Referred for endoscopy.  Zanco J Med Sci, 2010:14, 37-43.
22.Nibras S. Al-Ammar1, Saad S. Hamadi, et al. Demographical Study of H. pylori Associated Gastritis. International Research Journal of Microbiology 2011;2 :056-62.
23.Chariya Chomvarin a, Wises Namwat a, Kunyaluk Ch.et al .Prevalence of Helicobacter pylori vacA, cagA, cagE, iceA and babA2 genotypes in Thai dyspeptic patients.Int J Infect Dis. 2008; 12:30-6.
24.Muhammad K. Hassan, Moeen-ul Haq, Naimatullah Khan.The frequency of H. pylori infection in patient with functional dyspepsia.Gomal Journal of Medical Sciences 2013, Vol. 11:183-86.
25.Patchett S, Beattie S, Leen E, et al. Eradicating Helicobacter pylori and symptoms of non-ulcer dyspepsia. Br Med J 1991; 303:1238-40.
26.Salankar HV, Rode SB, Hemnani TJ.  Sociodemographic profile of Helicobacter pylori positive functional dyspepsia patients in central India. Int J Basic Clin Pharmacol 2015; 4:483-87.
27.J.L. Rodríguez-Garcíaa, R. Carmona-Sánchez. Functional dyspepsia and dyspepsia associated with Helicobacter pylori infection: Do they have different clinical characteristics?Rev Gastroenterol Mex. 2016; 81:126-33.  
28.Ching Chu LO. Comparison of clinical, serological and histological findings between non-ulcer dyspepsia with and without helicobacter pylori infection. Journal of Gastroenterology and Hepatology 2001; 16:276-81. 
29.G. maconi.Is routine histological evaluation an accurate test for helicobacter pylori infection? AlimentPharmacolTher1999;13:327-31.
 
Iraqi Postgraduate Medical Journal
Volume 21, Issue 4
October 2022
Page 449-453
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