scholarly journals Eradication of Helicobacter pylori may improve dyspepsia in the elderly for the long term

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ikko Tanaka ◽  
Shoko Ono ◽  
Yoshihiko Shimoda ◽  
Masaki Inoue ◽  
Sayoko Kinowaki ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Elderly Patients ◽  
Epigastric Pain ◽  
Eradication Therapy ◽  
The Elderly ◽  
Long Term Effects ◽  
Postprandial Fullness ◽  
Abdominal Symptoms ◽  
H Pylori

Abstract Background Therapy for eradication of Helicobacter pylori (H. pylori) improves symptoms of H. pylori-associated dyspepsia (HPD), but the effects of eradication in elderly patients are unclear. The aim of our study was to investigate dyspepsia symptoms and long-term effects of eradication in elderly patients. Methods This retrospective study included 496 patients who received H. pylori eradication therapy. The patients were divided into a group of elderly patients (group E: ≧ 65 years old) and a group of non-elderly patients (group N: < 65 years old). Abdominal symptoms were evaluated using a questionnaire about abdominal symptoms before eradication and after eradication (1–2 months and more than one year). Dyspepsia was defined as a score of 4 points or more for at least one of 4 items (postprandial fullness, early satiety, epigastric pain, and hunger pain). Improvement of symptoms was defined on the basis of changes in Global Overall Systems scores. Results There were no differences in abdominal symptoms before eradication between the two groups. Successful eradication improved symptoms in patients with dyspepsia within 2 months (in 75.6% (56/74) of the patients in group N and in 64.5% (20/31) of the patients in group E). The questionnaire showed that 80% (32/40) of the patients in group N and 60% (12/20) of the patients in group E had long-term relief of dyspepsia. The scores for abdominal symptoms in group E continued to improve for a mean period of 54.8 months after eradication. Conclusions Eradication of H. pylori age-independently improved dyspepsia symptoms for the long term.

scholarly journals Eradication of Helicobacter Pylori Improves Dyspepsia Symptoms in Elderly People

2020 ◽  
Author(s):  
Ikko Tanaka ◽  
Shoko Ono ◽  
Yoshihiko Shimoda ◽  
Masaki Inoue ◽  
Sayoko Kinowaki ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Elderly Patients ◽  
Eradication Rate ◽  
Epigastric Pain ◽  
Eradication Therapy ◽  
Serious Adverse Events ◽  
Postprandial Fullness ◽  
Abdominal Symptoms ◽  
H Pylori ◽  
One Year

Abstract BackgroundTherapy for eradication of Helicobacter pylori (H. pylori) improves symptoms of H. pylori-associated dyspepsia (HPD), but the effects of eradication in elderly patients are unclear. AimsTo evaluate the outcomes of eradication therapy and effects of eradication on dyspepsia symptoms in elderly patients.MethodsThis retrospective study included 496 patients who received H. pylori eradication therapy. The patients were divided into a group of elderly patients (group E: ≧ 65 years old) and a group of non-elderly patients (group N: < 65 years old). Abdominal symptoms were evaluated using a questionnaire about 12 abdominal symptoms before eradication and after eradication (1-2 months and more than one year). Dyspepsia was defined as a score of 4 points or more score for at least one of 4 items (postprandial fullness, early satiety, epigastric pain, and hunger pain).ResultsSuccesful H. pylori eradication rate in group E was significantly lower than that in group N (74.7 % vs. 84.4 %, P < 0.05) and it was remarkable in the 3rd-line therapy (59.7 % vs. 76.5 %, P < 0.05). Serious adverse events did not occur in either groups. Successful eradication improved symptoms in patients with dyspepsia in both groups within 2 months (70.3% of the patients in group N, 76.2% of the patients in group E) and decrease of GOS score lasted for more than 1 year.ConclusionsH. pylori eradication would be recommend for elderly patients with dyspepsia symptoms.

scholarly journals Mass eradication of Helicobacter pylori to reduce gastric cancer incidence and mortality: a long-term cohort study on Matsu Islands

Gut ◽  
2020 ◽  
pp. gutjnl-2020-322200 ◽  
Author(s):  
Tsung-Hsien Chiang ◽  
Wei-Jung Chang ◽  
Sam Li-Sheng Chen ◽  
Amy Ming-Fang Yen ◽  
Jean Ching-Yuan Fann ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Helicobacter Pylori ◽  
Cancer Incidence ◽  
Control Period ◽  
Eradication Therapy ◽  
Incidence Rates ◽  
Long Term Effects ◽  
Incidence And Mortality ◽  
H Pylori

ObjectiveAlthough mass eradication of Helicobacter pylori has been proposed as a means to eliminate gastric cancer, its long-term effects remain unclear.DesignMass eradication of H. pylori infection was launched in 2004 and continued until 2018 for a high-risk Taiwanese population aged 30 years or older dwelling on Matsu Islands with prevalent H. pylori infection. Test positives for the 13C-urea breath test underwent eradication therapy. We evaluated the effectiveness of the mass eradication in reducing two main outcomes, incidence and mortality rates of gastric cancer, until the end of 2016 and 2018, respectively.ResultsAfter six rounds of mass screening and eradication, the coverage rate reached 85.5% (6512/7616). The referral rate for treatment was 93.5% (4286/4584). The prevalence rates of H. pylori fell from 64.2% to 15.0% with reinfection rates of less than 1% per person-year. The presence and severity of atrophic gastritis and intestinal metaplasia also decreased with time. Compared with the historical control period from 1995 to 2003, the effectiveness in reducing gastric cancer incidence and mortality during the chemoprevention period was 53% (95% CI 30% to 69%, p<0.001) and 25% (95% CI −14% to 51%, p=0.18), respectively. No significant changes were noted in the incidence rates of other digestive tract cancers or the antibiotic resistance rate of H. pylori.ConclusionPopulation-based eradication of H. pylori has significantly reduced gastric cancer incidence with no increase in the likelihood of adverse consequences. A significant reduction in mortality is likely to be achieved with a longer follow-up period.Trial registration numberNCT00155389

scholarly journals MALT lymphoma: epidemiology, clinical diagnosis and treatment

2018 ◽  
Vol 11 (3) ◽  
pp. 187-193 ◽  
Author(s):  
Petruta Violeta Filip ◽  
◽  
Denisa Cuciureanu ◽  
Laura Sorina Diaconu ◽  
Ana Maria Vladareanu ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
B Cell ◽  
Malt Lymphoma ◽  
Cell Lymphoma ◽  
Gastric Lymphoma ◽  
Eradication Therapy ◽  
B Cell Lymphoma ◽  
Gastric Malt Lymphoma ◽  
H Pylori

Primary gastric lymphoma (PGL) represents a rare pathology, which can be easily misdiagnosed because of unspecific symptoms of the digestive tract. Histologically, PGL can vary from indolent marginal zone B-cell lymphoma of the mucosa-associated lymphoid tissue (MALT) to aggressive diffuse large B-cell lymphoma (DLBCL). During the years, clinical trials revealed the important role of Helicobacter pylori (H. pylori) in the pathogenesis of gastric MALT lymphoma. Infection with Helicobacter pylori is an influential promoter of gastric lymphomagenesis initiation. Long-term studies revealed that eradication therapy could regress gastric lymphomas.

scholarly journals Relation between Helicobacter pylori infection and gastrointestinal symptoms and syndromes

Gut ◽  
1997 ◽  
Vol 41 (2) ◽  
pp. 169-176 ◽  
Author(s):  
S Rosenstock ◽  
L Kay ◽  
C Rosenstock ◽  
L P Andersen ◽  
O Bonnevie ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Epigastric Pain ◽  
Gastrointestinal Symptoms ◽  
Igg Antibodies ◽  
Serum Samples ◽  
Ulcer Disease ◽  
Abdominal Symptoms ◽  
Nocturnal Pain ◽  
H Pylori ◽  
Upper Dyspepsia

Background—Helicobacter pylori is a human pathogen that colonises the gastric mucosa and causes permanent gastric inflammation.Aims—To assess the symptoms of H pylori infection in an adult unselected population.Subjects—A random sample of 3589 adult Danes who were examined in 1982 and 1987 (n=2987).Methods—Abdominal symptoms within the preceding year were recorded at both attendances. Circulating IgG antibodies against H pylori in serum samples drawn in 1982 were measured by using in-house indirect enzyme linked immunosorbent assays (ELISA).Results—People with increased levels of IgG antibodies to H pylori were more likely than uninfected individuals to report heartburn (odds ratio (OR) = 1.26, 95% confidence interval (CI) 1.03–1.54) and abdominal pain characterised by daily length (OR = 1.33, 95% CI 0.92–1.91), nocturnal occurrence (OR = 1.62, 95% CI 1.19–2.19), spring aggravation (OR = 1.68, 95% CI 0.70–4.05), and no relation to meals (OR = 0.62, 95% CI 0.43–0.91) or stress (OR = 0.69, 95% CI 0.50–0.95). The inclusion of people with increased levels of IgG antibodies to H pylori, but without upper dyspepsia, at study entry significantly increased the likelihood of reporting upper dyspepsia at follow up (OR = 1.71, 95% CI 1.24–2.36). People with epigastric pain and increased levels of IgM antibodies to H pylori only indicative of acute H pylori infection were more likely to report nocturnal pain, heartburn, nausea, and vomiting.Conclusions—H pylori infection may precede the development of dyspepsia and is associated with a variety of gastrointestinal symptoms in people with no history of peptic ulcer disease.

scholarly journals Cardiac Effects of Anticancer Therapy in the Elderly

2014 ◽  
Vol 32 (24) ◽  
pp. 2654-2661 ◽  
Author(s):  
Melissa K. Accordino ◽  
Alfred I. Neugut ◽  
Dawn L. Hershman
Keyword(s):  
Clinical Trial ◽  
Elderly Patients ◽  
Clinical Trial Data ◽  
The Elderly ◽  
Cardiac Risk ◽  
Long Term Effects ◽  
Cardiac Events ◽  
Long Term Follow Up ◽  
Clinical Trial Evidence

Cancer incidence increases with age, and as life expectancy increases, the number of elderly patients with cancer is increasing. Cancer treatments, including chemotherapy and radiotherapy, have significant short- and long-term effects on cardiovascular function. These cardiotoxic effects can be acute, such as changes in electrocardiogram (ECG), arrhythmias, ischemia, and pericarditis and/or myocarditis-like syndromes, or they can be chronic, such as ventricular dysfunction. Anticancer therapies can also have indirect effects, such as alterations in blood pressure, or can cause metabolic abnormalities that subsequently increase risk for cardiac events. In this review, we explore both observational and clinical trial evidence of cardiac risk in the elderly. In both observational and clinical trial data, risk of cardiotoxicity with anthracycline-based chemotherapy increases with age. However, it is less clear whether the association between age and cardiotoxicity exists for newer treatments. The association may not be well demonstrated as a result of under-representation of elderly patients in clinical trials and avoidance of these therapies in this population. In addition, we discuss strategies for surveillance and prevention of cardiotoxicity in the elderly. In the elderly, it is important to be aware of the potential for cardiotoxicity during long-term follow-up and to consider both prevention and surveillance of these late effects.

scholarly journals Cobalamin Deficiency in Elderly Patients: A Personal View

2008 ◽  
Vol 2008 ◽  
pp. 1-7 ◽  
Author(s):  
Emmanuel Andrès ◽  
Thomas Vogel ◽  
Laure Federici ◽  
Jacques Zimmer ◽  
Ecaterina Ciobanu ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Elderly Patients ◽  
Clinical Manifestations ◽  
Vitamin B12 Deficiency ◽  
The Elderly ◽  
Cobalamin Deficiency ◽  
Personal View ◽  
B12 Deficiency ◽  
Cobalamin Malabsorption

Cobalamin (vitamin B12) deficiency is particularly common in the elderly (>65 years of age) but is often unrecognized because its clinical manifestations are subtle; however, they are also potentially serious, particularly from a neuropsychiatric and hematological perspective. In the elderly, the main causes of cobalamin deficiency are pernicious anemia and food-cobalamin malabsorption. Food-cobalamin malabsorption syndrome is a disorder characterized by the inability to release cobalamin from food or its binding proteins. This syndrome is usually caused by atrophic gastritis, related or unrelated toHelicobacter pyloriinfection, and long-term ingestion of antacids and biguanides. Management of cobalamin deficiency with cobalamin injections is currently well documented but new routes of cobalamin administration (oral and nasal) are being studied, especially oral cobalamin therapy for food-cobalamin malabsorption.

CHRONIC GASTRITIS AND OLD AGE: A PROBLEM OR NOT?

2020 ◽  
pp. 30-39
Author(s):  
Zh.G. Simonova ◽  
M.N. Prikhod'ko ◽  
E.M. Shul'gina
Keyword(s):  
Helicobacter Pylori ◽  
Gastric Mucosa ◽  
Elderly Patients ◽  
Old Age ◽  
Chronic Gastritis ◽  
Morphological Changes ◽  
Eradication Therapy ◽  
Prospective Clinical Study ◽  
H Pylori ◽  
Endoscopic Picture

The objective of the paper is to study the clinical and functional characteristics of chronic H. pylori-associated gastritis in the elderly patients. Materials and Methods. A group of elderly patients (n=116) (aged 69.5±3.2) with chronic H. pylori-associated gastritis was formed during a prospective clinical study. All patients underwent esophagogastroduodenoscopy with biopsy. OLGA staging system was used for histological assessment. The dyspeptic index (DI) was used to measure dyspepsia. The patients were followed up for 48 weeks. Results. Dyspepsia was found only in 41.3 % of patients, while 58.7 % of patients had asymptomatic disease progression. Atrophic changes in the gastric mucosa were found in 30.1 % of the trial subjects. The efficacy of the eradication therapy was 88.7 %. During the study, the endoscopic picture of the gastroduodenal zone improved. There was no progression of atrophic and metaplastic changes in the gastric mucosa. Conclusion. Thus, in elderly patients, chronic H. pylori-associated gastritis is often asymptomatic. Eradication of H. pylori infection promotes disease remission and prevents morphological changes in the gastric mucosa. Keywords: chronic gastritis, Helicobacter pylori, atrophic gastritis, dyspepsia, old age, eradication therapy. Цель – изучить клинико-функциональные особенности течения хронического H. pylori-ассоциированного гастрита у лиц пожилого возраста. Материалы и методы. В процессе проспективного клинического исследования была сформирована группа больных (n=116) пожилого возраста (69,5±3,2 года) с хроническим H. pylori-ассоциированным гастритом. Всем больным была выполнена эзофагогастродуоденоскопия с биопсией. Для гистологической оценки применяли классификацию OLGA. Для оценки диспепсического синдрома использовали диспепсический индекс (ДИ). Длительность наблюдения больных составила 48 нед. Результаты. Наличие диспепсического синдрома было установлено у 41,3 % больных, 58,7 % пациентов имели бессимптомное течение заболевания. У 30,1 % обследуемых выявлены атрофические изменения слизистой оболочки желудка. Эффективность проведенной эрадикационной терапии составила 88,7 %. В процессе исследования установлено улучшение эндоскопической картины гастродуоденальной зоны. Отмечено отсутствие прогрессирования атрофических и метапластических изменений слизистой оболочки желудка. Выводы. У больных пожилого возраста течение хронического H. pylori-ассоциированного гастрита чаще имеет бессимптомный характер. Эрадикация инфекции H. pylori способствует ремиссии заболевания и предотвращает морфологические преобразования слизистой оболочки желудка. Ключевые слова: хронический гастрит, Helicobacter pylori, атрофический гастрит, синдром диспепсии, пожилой возраст, эрадикационная терапия.

scholarly journals Long-term persistence of gastric dysbiosis after eradication of Helicobacter pylori in patients who underwent endoscopic submucosal dissection for early gastric cancer

2020 ◽  
Author(s):  
Toshio Watanabe ◽  
Yuji Nadatani ◽  
Wataru Suda ◽  
Akira Higashimori ◽  
Koji Otani ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Helicobacter Pylori ◽  
Endoscopic Submucosal Dissection ◽  
Eradication Therapy ◽  
Bacterial Composition ◽  
Submucosal Dissection ◽  
History Of ◽  
H Pylori

Abstract Background Gastric microbiome, other than Helicobacter pylori, plays a role in the tumorigenesis of gastric cancer (GC). Patients who undergo endoscopic submucosal dissection for early GC have a high risk of developing metachronous GC even after successful eradication of H. pylori. Thus, we investigated the microbial profiles and associated changes in such patients after the eradication of H. pylori. Methods A total of 19 H. pylori-infected patients with early GC who were or to be treated by endoscopic resection, with paired biopsy samples at pre- and post-eradication therapy, were retrospectively enrolled. Ten H. pylori-negative patients were enrolled as controls. Biopsy samples were analyzed using 16S rRNA sequencing. Results H. pylori-positive patients exhibited low richness and evenness of bacteria with the deletion of several genera, including Blautia, Ralstonia, Faecalibacterium, Methylobacterium, and Megamonas. H. pylori eradication partially restored microbial diversity, as assessed during a median follow-up at 13 months after eradication therapy. However, post-eradication patients had less diversity than that in the controls and possessed a lower abundance of the five genera mentioned above. The eradication of H. pylori also altered the bacterial composition, but not to the same extent as that in controls. The microbial communities could be clustered into three separate groups: H. pylori-negative, pre-eradication, and post-eradication. Conclusion Changes in dysbiosis may persist long after the eradication of H. pylori in patients with a history of GC. Dysbiosis may be involved in the development of both primary and metachronous GC after the eradication of H. pylori in such patients.

scholarly journals Long-term effects of Helicobacter pylori eradication on circulating ghrelin and leptin concentrations and body composition in prepubertal children

2008 ◽  
Vol 158 (3) ◽  
pp. 323-332 ◽  
Author(s):  
Lucia Pacifico ◽  
Caterina Anania ◽  
John F Osborn ◽  
Eva Ferrara ◽  
Elisa Schiavo ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Body Composition ◽  
Fat Mass ◽  
Inverse Correlation ◽  
Study Groups ◽  
Long Term Effects ◽  
Prepubertal Children ◽  
H Pylori ◽  
Circulating Levels

BackgroundHelicobacter pylori, and the chronic gastric inflammation that it causes, may compromise the function and survival of ghrelin-producing cells, resulting in a decrease of circulating ghrelin levels. This finding raises the possibility that the infection might affect growth in children by reducing the ghrelin production.AimsTo determine baseline circulating levels of ghrelin and leptin in prepubertal children with and without H. pylori infection and to evaluate the long-term effects of H. pylori eradication on circulating levels of ghrelin and leptin as well as on body composition.PatientsThirty children with H. pylori-associated gastritis, 35 children with H. pylori-negative gastric mucosa, and 20 healthy controls were studied.ResultsAt baseline, while leptin levels were significantly lower in H. pylori-positive patients, ghrelin concentrations did not differ among the three study groups. However, a significant inverse correlation between ghrelin concentrations and histological severity of gastritis was found. Eradication of the organism was associated with a progressive decrease in ghrelin concentrations over baseline at both 6- and 12-month follow-ups. SDS-body mass index (BMI), lean and fat mass, as well as leptin concentrations, significantly increased over baseline at both follow-ups.ConclusionsIn prepubertal children, serum ghrelin concentrations are inversely related to the severity of H. pylori-associated gastritis. In these youngsters, long-term eradication of H. pylori infection is associated with a significant increase in BMI, lean and fat mass along with a significant decrease in circulating ghrelin levels and an increase in leptin levels.

scholarly journals Helicobacter pylori Infection in Geriatric Patients: Current Situation and Treatment Regimens

2021 ◽  
Vol 8 ◽  
Author(s):  
Qiuyue Huang ◽  
Xiaofen Jia ◽  
Yingming Chu ◽  
Xuezhi Zhang ◽  
Hui Ye
Keyword(s):  
Gastric Cancer ◽  
Helicobacter Pylori ◽  
Eradication Therapy ◽  
Dual Therapy ◽  
The Elderly ◽  
Complementary Therapy ◽  
Gastric Mucosal Lesions ◽  
Treatment Regimens ◽  
Elderly Health ◽  
H Pylori

Helicobacter pylori (H. pylori) has so far infected more than half the global population. It is the most important and controllable risk factor for gastric cancer. The elderly, who are at a higher incidence of the infection, are also commonly found to develop antibiotic resistance. The symptoms, diagnosis, clinical features (of gastric or extra-digestive diseases), and treatment of H. pylori infection in the elderly, are different from that in the non-elderly. Health conditions, including comorbidities and combined medication have limited the use of regular therapies in elderly patients. However, they can still benefit from eradication therapy, thus preventing gastric mucosal lesions and gastric cancer. In addition, new approaches, such as dual therapy and complementary therapy, have the potential to treat older patients with H. pylori infection.

Sign in / Sign up

Export Citation Format

Share Document