Bleeding gastroduodenal ulcers in patients without Helicobacter pylori infection and without exposure to non-steroidal anti-inflammatory drugs

Background/Aim. A high risk of bleeding in Helicobacter pylori (H.pylori)-negative, non-steroidal anti-inflammatory drugs (NSAID)-negative ulcers highlights the clinical importance of analysis of the changing trends of peptic ulcer disease. The aim of the study was to investigate the risk factors for ulcer bleeding in patients with non-H. pylori infection, and with no NSAIDs use. Methods. A prospective study included patients with endoscopically diagnosed ulcer disease. The patients were without H. pylori infection (verified by pathohistology and serology) and without exposure to NSAIDs and proton pump inhibitors (PPI) within 4 weeks before endoscopy. After endoscopy the patients were divided into 2 groups: the study group of 48 patients with bleeding ulcer and the control group of 47 patients with ulcer, but with no bleeding. Prior to endoscopy they had completed a questionnaire about demographics, risk factors and habits. The platelet function, von Willebrand factor (vWF) and blood groups were determined. Histopathological analysis of biopsy samples were performed with a modified Sydney system. The influence of bile reflux was analyzed by Bile reflux index (BRI). Results. Age, gender, tobacco and alcohol use did not affect the bleeding rate. The risk of bleeding did not depend on concomitant diseases (p = 0.509) and exposure to stress (p = 0.944). Aspirin was used by 16/48 (33.3%) patients with bleeding ulcer, as opposed to 7/47 (14.9%) patients who did not bleed (p = 0.036). Abnormal platelet function had 12/48 (25.0%) patients who bled, as opposed to 2/47 (4.3%) patients who did not bleed (p = 0.004). Patients with BRI < 14 bled in 79.2%, and did not bleed in 57.4% of the cases (p = 0.023). There was no statistical difference between groups in regards to blood groups and range of vWF. Antrum atrophy was found in 14/48 (29.2%) patients with bleeding ulcer and in only 5/47 (10.6%) patients who had ulcer without bleeding (p = 0.024). Conclusion. Abnormal platelet function, aspirin use and antrum atrophy were the risk factors for ulcer bleeding in non-H. pylori, non- NSAIDs ulcer disease.

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Association of Helicobacter Pylori with Peptic Ulcer Perforation

Journal of BP Koirala Institute of Health Sciences ◽

10.3126/jbpkihs.v2i1.24960 ◽

2019 ◽

Vol 2 (1) ◽

pp. 4-10

Author(s):

Sunit Agrawal ◽

D Thakur ◽

P Kafle ◽

A Koirala ◽

R K Sanjana ◽

...

Keyword(s):

Risk Factors ◽

Helicobacter Pylori ◽

Peptic Ulcer ◽

Peptic Ulcer Disease ◽

Perforated Peptic Ulcer ◽

Patch Repair ◽

Peptic Ulcer Perforation ◽

Ulcer Disease ◽

Ulcer Perforation ◽

H Pylori

Background: Helicobacter pylori is found in more than 90% cases of peptic ulcer. This study examines the possibility of association of Helicobacter pylori in perforated peptic ulcer disease and its relation to persisting ulcer as well as the influence of other risk factors; namely: smoking, alcohol, current non-steroidal anti inflammatory drugs (NSAIDs) and steroid use. Materials and Methods: In this prospective study, total of 50 cases of peptic ulcer perforation admitted in College of Medical Sciences and Teaching Hospital, Bharatpur, Nepal were selected on the basis of the non-probability (purposive) sampling method. All patients who presented with suspected peptic ulcer perforation were included in the study and the perforations were repaired by Modified Graham’s Patch and were given triple therapy postoperatively. The age, sex, incidence, mode of presentation, precipitating factors, association with the risk factors and postoperative complications were all evaluated and compared. Results: Of 50 patients studied, the age ranged from 17 to 75 years, mean age being 40.1 years with the peak incidence in the 3rd and 5th decades of life showing a male dominance (92%). H. pylori was seen in ulcer edge biopsy in 29 patients (58%). Most common clinical presentation was pain abdomen, the most common signs of perforation were tenderness, rebound tenderness and absent bowel sounds. The mean duration of stay in hospital in H. pylori positive patients was 12.07±8.15 days as compared with 11.1±5.12 days in H. pylori negative patients. The incidence of peptic ulcer perforation was higher in the patients consuming alcohol (64%) than smokers (48%), followed by NSAIDs user(22%). 20% of the patients with delayed presentation developed complications postoperatively. Perforated peptic ulcer was repaired by Modified Graham’s Patch Repair, followed by anti H. pylori therapy in all of them. Conclusion: Peptic ulcer perforation is quite common among the patients with peptic ulcer disease with history of chronic smoking, alcoholism and analgesic intake, more commonly in males. There is association of H. pylori in 58% of patients with peptic ulcer perforation.

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Significance of Helicobacter pylori infection and nonsteroidal anti-inflammatory drugs in patients with bleeding from upper part of the gastrointestinal tract

Vojnosanitetski pregled ◽

10.2298/vsp0707445g ◽

2007 ◽

Vol 64 (7) ◽

pp. 445-448

Author(s):

Gradimir Golubovic ◽

Ratko Tomasevic ◽

Biljana Radojevic ◽

Aleksandar Pavlovic ◽

Predrag Dugalic

Keyword(s):

Helicobacter Pylori ◽

Peptic Ulcer ◽

Gastrointestinal Bleeding ◽

Upper Gastrointestinal Bleeding ◽

Ulcer Bleeding ◽

Significant Difference ◽

Inflammatory Drugs ◽

Anti Inflammatory ◽

H Pylori ◽

Upper Gastrointestinal

Background/Aim. Helicobacter pylori (H. pylori) infection and nonsteroidal anti-inflammatory drugs (NSAIDs) use are considered to be the most important risk factors having influence on the onset of bleeding gastroduodenal lesions. Whether there is an interaction between H. pylori infection and the use of NSAIDs in the development of peptic ulcer disease is still controversial. The aim of the present study was to evaluate the prevalence of NSAIDs use and H. pylori infection in patients presented with bleeding gastroduodenal lesions. Methods. During the period from January 2003 - December 2003 we prospectively obtained data of all the patients (n=106) presented with signs of upper gastrointestinal bleeding. All the patients were admitted to the intensive care unit, with the endoscopy performed within 12 hours after admission. Histologic analysis was used for the detection of H. pylori infection. The NSAIDs and aspirin use data were obtained by anamnesis. Results. The results of our study revealed that the most common sources of upper gastrointestinal bleeding were duodenal (57 patients, 53.77%) and ventricular (36 patients, 33.96%) ulcers. The majority of the examined cases were associated with both H. pylori infection and NSAIDs use. A statistically significant difference among the studied groups of patients was proven. Conclusion. The majority of bleeding gastroduodenal lesions were associated with the coexistence of H. pylori infection and NSAIDs use, while their independent influences were statistically less important. Eradication of H. pylori infection in patients using NSAIDs might prevent upper gastrointestinal hemorrhage and reduce peptic ulcer bleeding risk. .

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Absence of Helicobacter pylori is not protective against peptic ulcer bleeding in elderly on offending agents: lessons from an exceptionally low prevalence population

10.7287/peerj.preprints.180v1 ◽

2013 ◽

Author(s):

Yeong Yeh Lee ◽

Nordin Noridah ◽

Syed Abdul Aziz Syed Hassan ◽

Jayaram Menon

Keyword(s):

Risk Factors ◽

Helicobacter Pylori ◽

Peptic Ulcer ◽

Hospital Mortality ◽

Ulcer Bleeding ◽

Recurrent Bleeding ◽

Gi Bleeding ◽

Peptic Ulcer Bleeding ◽

H Pylori ◽

Risk For Bleeding

Aim Helicobacter pylori (H. pylori) infection is exceptionally rare in population from the north-eastern region of Peninsular Malaysia. This provides us an opportunity to contemplate the future without H. pylori in acute non-variceal upper gastrointestinal (GI) bleeding.Methods All prospective cases in the GI database registry with GI bleeding between 2003 and 2006 were reviewed. Cases with confirmed non-variceal aetiology were analysed. Rockall score > 5 was considered high risk for bleeding and primary outcomes studied were in-hospital mortality, recurrent bleeding and need for surgery. Results The incidence of non-variceal upper GI bleeding was 2.2/100,000 person-years. Peptic ulcer bleeding was the most common aetiology (1.8/100,000 person-years). In-hospital mortality (3.6%), recurrent bleeding (9.6%) and need for surgery (4.0%) were uncommon in this population with a largely low risk score (85.2% with score ≤ 5). Elderly were at greater risk for bleeding (mean 68.5 years, P = 0.01) especially in the presence of duodenal ulcers (P = 0.04) despite gastric ulcers being more common. NSAIDs (34%) and aspirin (22.8%) were the main risk factors. Conclusions The absence of H. pylori infection may not reduce the risk of peptic ulcer bleeding in the presence of risk factors especially offending drugs in the elderly.

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Better Outcome in Laparoscopic Gastric Ulcer Perforation Than Laparotomy : Single Center Experience

Medical & Clinical Research ◽

10.33140/mcr.02.04.04 ◽

2017 ◽

Vol 2 (4) ◽

Keyword(s):

Helicobacter Pylori ◽

Risk Factor ◽

Gastric Ulcer ◽

Seasonal Variation ◽

Single Center ◽

Ulcer Disease ◽

Single Center Experience ◽

The World ◽

Inflammatory Drugs ◽

H Pylori

Each year gastric ulcer disease (PUD) affects 4 million people around the world. Complications are encountered in 10%-20% of these patients and 2%-14% of the ulcers will perforate [1]. Females account for more than half the cases, they are older and have more comorbidity than their male counterparts. Main etiologic factors include use of non-steroidal anti-inflammatory drugs (NSAIDs), steroids, smoking, Helicobacter pylori (H. pylori) and a diet high in salt. All these factors have in common that they affect acid secretion in the gastric mucosa. Defining the exact etiological factor in any given patient may often be difficult, as more than one risk factor may be present and they tend to interact [2]. While previous reports have shown a seasonal variation in the incidence of PPU, others have failed to find such a pattern [3].

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Helicobacter pylori Seropositivity in Children in Duhok City, Iraq

Science Journal of University of Zakho ◽

10.25271/sjuoz.2018.6.3.508 ◽

2018 ◽

Vol 6 (3) ◽

pp. 82-87 ◽

Cited By ~ 1

Author(s):

Nizar B. Yahya

Keyword(s):

Risk Factors ◽

Helicobacter Pylori ◽

Positive Association ◽

Significant Positive Association ◽

Ulcer Disease ◽

Face To Face ◽

Pediatric Age Group ◽

Significant Relationships ◽

H Pylori ◽

Associated Risk Factors

Introduction: Helicobacter pylori(H. pylori) is a gram negative bacteria that causes gastritis and peptic ulcer disease (PUD). It is widely accepted that the infection may occur early in life and may persist for decades before causing diseases. The aim of this paper was to determine the prevalence of H. pyloriseropositivity in pediatric age group and to examine the associated risk factors. Patients and methods: Blood samples were collected from 100 subjects attending Hevi Pediatric Teaching Hospital over a period of 6 months and IgG positivity was determined. A questionnaire sheet was prepared and used for each study subject. Data were collected by a face-to-face interview.Results: It was found that 28/100 (28%) of the recruited sample was positive for H. pyloriseropositivity. A significant association was found between the number of siblings and H. pyloripositivity (P=0.01, OR=1.3). No significant relationships were found between other factors and H. pyloripositivity. Conclusions: The prevalence of H. pyloriinfection was less than that reported in the city previously and less than that reported in neighboring countries. A significant positive association was found between number siblings and H. pyloriinfection rate. Further studies are needed recruiting larger sample size to explore H. pyloriprevalence and its associated risk factors.

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Absence of Helicobacter pylori is not protective against peptic ulcer bleeding in elderly on offending agents: lessons from an exceptionally low prevalence population

10.7287/peerj.preprints.180 ◽

2013 ◽

Author(s):

Yeong Yeh Lee ◽

Nordin Noridah ◽

Syed Abdul Aziz Syed Hassan ◽

Jayaram Menon

Keyword(s):

Risk Factors ◽

Helicobacter Pylori ◽

Peptic Ulcer ◽

Hospital Mortality ◽

Ulcer Bleeding ◽

Recurrent Bleeding ◽

Gi Bleeding ◽

Peptic Ulcer Bleeding ◽

H Pylori ◽

Risk For Bleeding

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A STUDY ON PREVALENCE OF HELICOBACTER PYLORI IN BLEEDING PEPTIC ULCER USING RAPID UREASE TEST

10.36106/ijsr/4914430 ◽

2021 ◽

pp. 82-83

Author(s):

Lokesh M N ◽

Anil Kumar K N ◽

Madan M

Keyword(s):

Duodenal Ulcer ◽

Helicobacter Pylori ◽

Peptic Ulcer ◽

Peptic Ulcer Disease ◽

Bleeding Peptic Ulcer ◽

Ulcer Bleeding ◽

Rapid Urease Test ◽

Ulcer Disease ◽

Urease Test ◽

H Pylori

BACKGROUND: Helicobacter pylori (H. pylori) is the leading cause of peptic ulcer disease in India. Timely diagnosis and proper treatment is required for the eradication of H. pylori infection and prevention of its associated complications. AIMS AND OBJECTIVES: This study aims to evaluate the prevalence of H. pylori infection in patients presenting with bleeding peptic ulcer. MATERIAL AND METHODS: This is prospective study conducted from January 2019 till January 2021 in patients with bleeding peptic ulcer admitted at BGS Global Institute of Medical Sciences. All the patients under went endoscopy and biopsy was taken from Antral region for Rapid Urease Test. RESULT: 164 patients were included in the study with duodenal ulcer bleeding in 129 (78.6%) patients, gastric ulcer in 30 (18.3%) patients and both gastric and duodenal ulcer in 5 (3.1%) patients. Positivity for RUT was seen in 147 patients (89.6%). CONCLUSION: Early intervention in the patients with peptic ulcer disease in the form of endoscopic biopsy will help in prevention of recurrent bleeding episodes and other associated complications.

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Intracellular Presence of Helicobacter pylori and Its Virulence-Associated Genotypes within the Vaginal Yeast of Term Pregnant Women

Microorganisms ◽

10.3390/microorganisms9010131 ◽

2021 ◽

Vol 9 (1) ◽

pp. 131

Author(s):

Kimberly Sánchez-Alonzo ◽

Lillian Matamala-Valdés ◽

Cristian Parra-Sepúlveda ◽

Humberto Bernasconi ◽

Víctor L. Campos ◽

...

Keyword(s):

Risk Factors ◽

Helicobacter Pylori ◽

Virulence Genes ◽

Yeast Cells ◽

Bacterial Identification ◽

Infection Risk Factors ◽

Horse Blood ◽

Total Dna ◽

H Pylori ◽

Total Yeast

Background: Helicobacter pylori transmission routes are not entirely elucidated. Since yeasts are postulated to transmit this pathogen, this study aimed to detect and genotype intracellular H. pylori harbored within vaginal yeast cells. Methods: A questionnaire was used to determine risk factors of H. pylori infection. Samples were seeded on Sabouraud Dextrose Agar and horse blood-supplemented Columbia agar. Isolated yeasts were identified using and observed by optical microscopy searching for intra-yeast H. pylori. Total yeast DNA, from one random sample, was extracted to search for H. pylori virulence genes by PCR and bacterial identification by sequencing. Results: 43% of samples contained yeasts, mainly Candida albicans (91%). Microscopy detected bacteria such as bodies and anti-H. pylori antibodies binding particles in 50% of the isolated yeasts. Total DNA extracted showed that 50% of the isolated yeasts were positive for H. pylori 16S rDNA and the sequence showed 99.8% similarity with H. pylori. In total, 32% of H. pylori DNA positive samples were cagA+ vacAs1a vacAm1 dupA−. No relationship was observed between possible H. pylori infection risk factors and vaginal yeasts harboring this bacterium. Conclusion: H. pylori having virulent genotypes were detected within vaginal yeasts constituting a risk for vertical transmission of this pathogen.

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Gastric Acid-Related Diseases: Focus on Esomeprazole

Clinical Medicine Insights Therapeutics ◽

10.4137/cmt.s4500 ◽

2010 ◽

Vol 2 ◽

pp. CMT.S4500

Author(s):

B. Al-Judaibi ◽

N. Chande ◽

G.K. Dresser ◽

N. Sultan ◽

J.C. Gregor

Keyword(s):

Duodenal Ulcer ◽

Helicobacter Pylori ◽

Symptom Relief ◽

Competitive Inhibitor ◽

Gastric Ph ◽

Disease Treatment ◽

Ulcer Disease ◽

Zollinger Ellison Syndrome ◽

Prevention And Treatment ◽

Inflammatory Drugs

Esomeprazole (S-omeprazole) is a single optical enantiomer proton-pump inhibitor (PPI) approved for the management of gastro-oesophageal reflux disease, the prevention and treatment of Non-Steroidal Anti-Inflammatory Drugs (NSAID) associated gastric ulcer disease, treatment of duodenal ulcer disease associated with Helicobacter pylori infection, and the treatment of Zollinger-Ellison syndrome. Esomeprazole has been shown to be safe and effective during pregnancy and was introduced to the market in 2001. PPI therapy may interact with clopidogrel by cytocrome 2C19. Clopidogrel is a prodrug which is partially activated by cytochrome 2C19 and esomeprazole is a competitive inhibitor of 2C19. Esomeprazole is more effective than other PPIs in controlling esophageal and gastric pH, but efficacy in symptom relief is less clear.

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Identification of Markers for Helicobacter pylori Strains Isolated from Children with Peptic Ulcer Disease by Suppressive Subtractive Hybridization

Infection and Immunity ◽

10.1128/iai.00123-06 ◽

2006 ◽

Vol 74 (7) ◽

pp. 4064-4074 ◽

Cited By ~ 34

Author(s):

Mónica Oleastro ◽

Lurdes Monteiro ◽

Philippe Lehours ◽

Francis Mégraud ◽

Armelle Ménard

Keyword(s):

Helicobacter Pylori ◽

Peptic Ulcer ◽

Peptic Ulcer Disease ◽

Subtractive Hybridization ◽

Suppressive Subtractive Hybridization ◽

Ulcer Disease ◽

Lipopolysaccharide Biosynthesis ◽

The Difference ◽

H Pylori

ABSTRACT Peptic ulcer disease (PUD) occurs after a long-term Helicobacter pylori infection. However, the disease can develop earlier, and rare cases have been observed in children, suggesting that these H. pylori strains may be more virulent. We used suppressive subtractive hybridization for comparative genomics between H. pylori strains isolated from a 5-year-old child with duodenal ulcer and from a sex- and age-matched child with gastritis only. The prevalence of the 30 tester-specific subtracted sequences was determined on a collection of H. pylori strains from children (15 ulcers and 30 gastritis) and from adults (46 ulcers and 44 gastritis). Two of these sequences, jhp0562 (80.0% versus 33.3%, P = 0.008) and jhp0870 (80.0% versus 36.7%, P = 0.015), were highly associated with PUD in children and a third sequence, jhp0828, was less associated (40.0% versus 10.0%, P = 0.048). Among adult strains, none of the 30 sequences was associated with PUD. However, both jhp0562 and jhp0870 were less prevalent in adenocarcinoma strains than in PUD strains from children and adults, the difference being statistically significant for jhp0870. In conclusion, two H. pylori genes were identified as being strongly associated with PUD in children, and their putative roles as an outer membrane protein for jhp0870 and in lipopolysaccharide biosynthesis for jhp0562, suggest that they may be novel virulence factors of H. pylori.

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