Helicobacter pylori Gastritis in Children—The Link between Endoscopy and Histology

Background: The management of Helicobacter pylori (H. pylori) infection raises important challenges, still being the most common chronic infection worldwide in all age groups. In high-prevalence regions, paediatric patients need a specific focus, as the acquisition of the infection takes place in childhood. The objective of this study was to analyze the endoscopic and histopathologic changes of the gastric mucosa in H. pylori infected children. Material and Methods: A retrospective study was performed on consecutive paediatric patients, ranging from 0 to 18 years of age, who underwent an upper gastrointestinal endoscopy (UGE) for a period of 5 years, regardless of their symptomatology. Endoscopy reports and histological slides were reviewed and clinical, endoscopic, and histologic data were recorded. Results: A total of 248 patients were included in the study, 82 (33.06%) of them being H. pylori infected. There was no difference in age and symptoms between the infected and noninfected group. A significant association was found between the H. pylori infection and histopathological parameters such as acute and chronic inflammatory infiltrate. The bacterial load influences the intensity of inflammation (p < 0.001). The chronic inflammation was predominant, only 23.2% of the patients displayed acute inflammation (p < 0.0001). The topographic distribution of inflammation was dominated by pangastritis (p = 0.04) with 58.6% of the patients presenting similar degrees of inflammation both in the antrum and corpus. Conclusion: Endoscopic features such as nodularity of the antral mucosa (p < 0.05) along with histological findings as lymphoid follicles (p < 0.05) are suggestive of H. pylori infection. However, the concordance between the endoscopic and histological diagnosis is still far from perfect (Cohen’s k coefficient = 0.42), maintaining the need for an invasive approach in children.

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Characteristics of Helicobacter pylori infection in a National Referral Hospital in Bhutan

Bhutan Health Journal ◽

10.47811/bhj.93 ◽

2020 ◽

Vol 6 (1) ◽

pp. 6-10

Author(s):

Chhabi Lal Adhikari ◽

Guru Prasad Dhakal ◽

Nongluck Suwisith ◽

Sonam Dargay ◽

Krishna P Sharma

Keyword(s):

Gastric Cancer ◽

Helicobacter Pylori ◽

Age Groups ◽

Referral Hospital ◽

Upper Gastrointestinal Endoscopy ◽

Age Group ◽

Exact Test ◽

Significant Difference ◽

H Pylori ◽

National Referral Hospital

Introduction: Helicobacter pylori (H. pylori) is a bacterium causing chronic gastric infection and may cause gastric cancer. It was necessary to see the trend of infection, especially in symptomatic patients. This retrospective descriptive study was aimed to describe the characteristics of H. pylori infection in Bhutanese patients referred for an endoscopy to the National Referral Hospital, Thimphu. Methods: The sample of the study was randomized 380 medical records of the patients who underwent upper gastrointestinal endoscopy and Rapid Urea Test for symptomatic dyspepsia and peptic ulcer. Data was collected using a survey form designed by the researchers. Data analysis was done using descriptive statistics and either Chi-square or Fisher’s exact test. Results: The prevalence of H. pylori infection was very high (76.6%). The mean age of the infection was 42 with a range from 15 to 84 years. The highest prevalence of infection was observed in the age group 20-29 years (82.7%) and lowest in the oldest age group 70-84 years (66.7%). The analysis showed no significant difference in infection amongst age groups, gender, and endoscopic findings to the positive results at 5% significant level except for monthly prevalence (p<0.001). Gastritis was the commonest endoscopy finding (153/380) and gastro-duodenitis had the highest positivity rate (88.9%). Conclusion: The prevalence of infection was relatively high compared with previous studies. Young and middle-aged adults had a high prevalence and this group needs to be given priority for screening and eradication treatment considering limited resources to prevent associated gastric cancer in Bhutan.

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Association of Helicobacter pylori infection with nodular antritis and follicular gastritis

Vojnosanitetski pregled ◽

10.2298/vsp0603313t ◽

2006 ◽

Vol 63 (3) ◽

pp. 313-315 ◽

Cited By ~ 2

Author(s):

Ratko Tomasevic ◽

Gradimir Golubovic ◽

Miroslav Kiurski ◽

Dragana Stankovic ◽

Radoje Doder ◽

...

Keyword(s):

Helicobacter Pylori ◽

Case Report ◽

Chronic Gastritis ◽

Upper Gastrointestinal Endoscopy ◽

Antral Mucosa ◽

Urease Test ◽

Sydney System ◽

H Pylori ◽

The Relationship ◽

Upper Gastrointestinal

Introduction. Helicobacter pylori (H. pylori) infection is known to be the must common cause of chronic gastritis having some endoscopic and pathologic characteristies as determinated by the Sydney System for Gastritis Classification. The aim of our case report was to point out the relationship between an endoscopic finding of nodular antritis and the presence of H. pylori infection and active chronic gastritis. Case report. Our patient underwent upper gastrointestinal endoscopy for dyspeptic complaints and was diagnosed as having nodular antritis, but also underwent urease test and hystopathologic examination of antral mucosa, to determine the presence and density of H. pylori infection and the presence and severity of gastritis. After a course of anti H. pylori treatment, dyspepsia improved and new biopsy specimens obtained two months and six months afterwards revealed no pathological findings. Conclusion. The case report supported the association of H. pylori infection of lymphoid follicles with nodular gastric mucosis.

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Clinical Relevance of Helicobacter pylori Infection

Journal of Clinical Medicine ◽

10.3390/jcm10163473 ◽

2021 ◽

Vol 10 (16) ◽

pp. 3473

Author(s):

Irena Mladenova

Keyword(s):

Helicobacter Pylori ◽

Age Groups ◽

Acid Resistance ◽

Clinical Indication ◽

Clinical Aspects ◽

Gastric Disease ◽

Upper Gastrointestinal Endoscopy ◽

World Population ◽

Ulcer Disease ◽

H Pylori

Helicobacter pylori (H. pylori) is a Gram-negative helical, microaerophilic bacterium which colonizes the antrum and body of the stomach, surviving in its harsh environment through mechanisms of acid resistance and colonization factors. It infects approximately 50% of the world population. Although the prevalence of this infection varies from country to country, as well as between different ethnic, social or age groups, it is estimated that about 50% of the human population only carries this microorganism. While H. pylori has been found to play a major etiological and pathogenic role in chronic gastritis, peptic ulcer disease and gastric cancer, its importance for many types of extra-gastric disease needs to be further investigated. The choice of tests to diagnose H. pylori infection, defined as invasive or non-invasive, depends on the clinical indication as to whether to perform upper gastrointestinal endoscopy. Focusing on bacterial eradication, the treatment should be decided locally based on the use of antibiotics and documented antibiotic resistance. The author provides an overview of the current state of knowledge about the clinical aspects of H. pylori infection, especially its diagnostic and therapeutic management.

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The impact of bismuth adding to rabeprazole, amoxicillin and clarithromycin on eradication rate of Helicobacter pylori

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20203149 ◽

2020 ◽

Vol 9 (8) ◽

pp. 1280

Author(s):

Mohammad Sadrkabir ◽

Masoud Tasouji ◽

Afshan Sharghi ◽

Abbas Yazdanbod

Keyword(s):

Helicobacter Pylori ◽

Eradication Rate ◽

High Prevalence ◽

Group A ◽

Stool Antigen ◽

The Difference ◽

H Pylori ◽

Group B ◽

The Impact ◽

Optimal Regimen

Background: High prevalence of Helicobacter pylori infection and induction of resistance as a result of consumption of antibiotics necessitates an ongoing effort for evaluation of new regimen to overcome this phenomenon. Intensive efforts are being made to identify such an optimal regimen, but there are many obstacles hindering the achievement of this goal. This study aimed to investigate the impact of adding bismuth to rabeprazole, amoxicillin and clarithromycin on rate of H. pylori eradication.Methods: In this randomized clinical trial, 60 patients with dyspepsia and positive gastric biopsy for H. pylori in endoscopy were recruited. The first group (A) received rabiprazole for 6 weeks, amoxicillin and clarithromycin for 2 weeks either with bismuth for 2 weeks and the second group (B) received rabiprazole for 6 weeks, amoxicillin and clarithromycin for 2 weeks either without bismuth. Four weeks after the treatment, the compliance and eradication were evaluated using stool antigen of helicobacter. The patients who could complete the therapeutic regimen were assigned for analysis.Results: H. pylori eradication rates were 70% and 56.6% in two groups A and B (with and without Bismuth), respectively and the difference was significant. There is a significant relationship between the studied groups and the results of fecal antigen of H. pylori.Conclusions: The bismuth had a significant effect on the success of eradication rate of H. pylori and its impact adding to the treatment regimen containing clarithromycin was effective on eradication success rate.

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Seroprevalence of Helicobacter pylori infection and gastric mucosal atrophy in Bhutan, a country with a high prevalence of gastric cancer

Journal of Medical Microbiology ◽

10.1099/jmm.0.060905-0 ◽

2013 ◽

Vol 62 (10) ◽

pp. 1571-1578 ◽

Cited By ~ 19

Author(s):

Seiji Shiota ◽

Varocha Mahachai ◽

Ratha-korn Vilaichone ◽

Thawee Ratanachu-ek ◽

Lotay Tshering ◽

...

Keyword(s):

Gastric Cancer ◽

Helicobacter Pylori ◽

Negative Group ◽

Mucosal Atrophy ◽

Gastric Mucosal Atrophy ◽

High Prevalence ◽

Group A ◽

H Pylori ◽

Group B ◽

Group D

Gastric cancer is the second leading cause of cancer-related mortality in the world. Recently, serum Helicobacter pylori antibodies and pepsinogen (PG) have been used for gastric cancer screening. The incidence of gastric cancer in Bhutan is reported to be quite high compared with that in neighbouring countries. In this study, 381 subjects from three areas of Bhutan were assessed for gastric mucosal atrophy and serological parameters. Anti-H. pylori IgG, PG I, PG II and cytotoxin-associated gene A (CagA) antibodies were measured using ELISA. Subjects were classified into four groups according to H. pylori and PG seropositivity: Group A (H. pylori-negative/PG-negative), Group B (H. pylori-positive/PG-negative), Group C (H. pylori-positive/PG-positive) and Group D (H. pylori-negative/PG-positive). The prevalence of H. pylori in the 381 subjects was 71.1 % (271/381), with high infection rates found in rural areas. The PG I/II ratio was significantly inversely correlated with the atrophy score in the antrum and the corpus (P<0.001). Multivariate analysis showed that the PG status was significantly associated with the presence of atrophy in the corpus. The prevalence of the PG-positive status was significantly higher among H. pylori-positive subjects than among H. pylori-negative subjects (P<0.001). Based on the ABC method, Group B was the most dominant, followed by Group A, Group C and Group D. The high incidence of gastric cancer in Bhutan can be attributed to the high prevalence of H. pylori infection and gastric mucosal atrophy.

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Moxifloxacin Based Triple Therapy as Alternative to Standard Therapy in Helicobacter Pylori Eradication.

Anti-Infective Agents ◽

10.2174/2211352518999200925154501 ◽

2020 ◽

Vol 18 ◽

Author(s):

Mohammed Hussien Ahmed ◽

Sherief Abd-Elsalam ◽

Aya Mohammed Mahrous

Keyword(s):

Helicobacter Pylori ◽

Triple Therapy ◽

Therapy Group ◽

Low Cost ◽

High Rate ◽

Helicobacter Pylori Eradication ◽

Treatment Regimens ◽

Group A ◽

H Pylori ◽

Group B

Introduction: Helicobacter pylori eradication remains a problematic issue. We are in an urgent need for finding a treatment regimen that achieves eradication at a low cost and less side effect. Recent published results showing a high rate of resistance and with clarithromycin-based treatment regimens. The aim of the study was to compare moxifloxacin therapy and classic clarithromycin triple therapy in H. pylori eradication. Methods: This was a pilot study that enrolled 60 patients with helicobacter pylori associated gastritis. Diagnosis was done by assessment of H. pylori Ag in the stool. The patients were randomly assigned to receive either moxifloxacin based therapy (Group A), or clarithromycin based therapy (Group B) for two weeks. We stopped the treatment for another two weeks then reevaluation for cure was done. Results: 90 % of patients had negative H. pylori Ag in the stool after 2 weeks of stoppage of the treatment in group A versus 66.7 % in Group B. None of the patients in both groups had major side effects. Conclusion: Moxifloxacin-based therapy showed higher eradication power and less resistance when compared to clarithromycin triple therapy.

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Perfil Epidemiológico de Pacientes Submetidos à Biópsia Gástrica em um Hospital Escola do Sul de Minas Gerais/ Epidemiological Profile of Patients Undergo Gastric Biopsy in a School Hospital of Minas Gerais

REVISTA CIÊNCIAS EM SAÚDE ◽

10.21876/rcsfmit.v4i3.229 ◽

1970 ◽

Vol 4 (3) ◽

pp. 48-57

Author(s):

Isabela Maria A. Ribeiro Simões ◽

Ana Carolina Mauad Coli ◽

Roseane de Souza Candido Irulegui

Keyword(s):

Helicobacter Pylori ◽

Age Groups ◽

Epidemiological Data ◽

Minas Gerais ◽

Gastric Biopsy ◽

Gastric Ulcers ◽

Histopathological Diagnosis ◽

Gastric Diseases ◽

H Pylori ◽

Epidemiological Profile

Objetivo: Determinar a prevalência de lesões benignas e neoplasia gástrica através do estudo de biópsias realizadas em um Hospital Escola do Sul de Minas Gerais, no período entre 2007 e 2011. Materiais e Métodos: A pesquisa documental foi quantitativa e retrospectiva, baseada na análise dos registros de biópsias e prontuários. Realizou-se o levantamento de dados referentes à idade, gênero, cor, profissão, diagnóstico histopatológico e presença de Helicobacter pylori nas amostras. Resultados: O número total de biópsias gástricas analisadas foi de 1225, cujo perfil populacional encontrado foi: idade média de 56,75 anos, sexo masculino (52%), cor branca (81,9 %), aposentado (30%). Os diagnósticos mais frequentes foram: gastrites (71,9%), pólipos (14,2%), adenocarcinomas (5,9%), úlceras gástricas (6%), linfomas (0,4%), sem alterações (0,4%) e outros (1,2%). Em outros, encontram-se achados de malignidade, metaplasia e xantelasma gástrico. Em relação à presença de Helicobacter pylori nas amostras, o resultado encontrado foi de24% positivas, 46% negativas e 30% não pesquisadas. Conclusão: Os resultados confirmam a alta frequência das doenças gástricas e sua incidência nas diversas faixas etárias, além do envolvimento do H. pylori em tais afecções. É de grande importância a caracterização dos dados epidemiológicos, o que permite prováveis direcionamentos para programas de prevenção e informação para a população. Palavras-chave: biópsia gástrica, gastropatia, perfil epidemiológico. ABSTRACTObjective: To determine the prevalence of benign lesions and gastric cancer through study of biopsies performed at a school hospital in southern Minas Gerais, in the period between 2007 and 2011.Materials and Methods: The research was quantitative and retrospective, based on analysis of biopsies records and medical records. We conducted the survey data regarding age, sex, color, profession, histopathological diagnosis and the presence of Helicobacter pylori in the samples. Results: The total number of gastric biopsies analyzed was 1225. Population listing was found: mean age of 56.75 years, male (52%), white (81.9%), retired (30%). The most frequent diagnoses were gastritis (71.9%), polyps (14.2%), adenocarcinomas (5.9%), gastric ulcers (6%), lymphoma (0.4%), unchanged (0, 4%) and others (1.2%). In others, there are: findings of malignancy, metaplasia, gastric xanthelasma. Regarding the presence of Helicobacter pylori in the sample, the result was: 24% positive, 46% negative, 30% non searched. Conclusion: The results confirm the high frequency of gastric diseases and their incidence in the various age groups additionally to the involvement of H. pylori in such conditions. It is of great importance to characterize the epidemiological data, allowing probable directions for prevention and information programs for population. Keywords: gastric biopsy, gastropathy, epidemiological profile

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Evaluation of Helicobacter pylory colonization by serologic test (IgG) and dyspepsia in volunteers from the countryside of Monte Negro, in the Brazilian western Amazon region

Revista do Instituto de Medicina Tropical de São Paulo ◽

10.1590/s0036-46652010000400007 ◽

2010 ◽

Vol 52 (4) ◽

pp. 203-206 ◽

Cited By ~ 3

Author(s):

Rafael Bernardon Ribeiro ◽

Herlon Saraiva Martins ◽

Vera Aparecida dos Santos ◽

Marcelo el Khouri ◽

Leandro Savoy Duarte ◽

...

Keyword(s):

Helicobacter Pylori ◽

Rural Areas ◽

Age Groups ◽

Developed Countries ◽

Progressive Increase ◽

Amazon Region ◽

Statistical Association ◽

Serologic Test ◽

Positive Serology ◽

H Pylori

The present study intended to analyze the seroprevalence of Helicobacter pylori, IgG, and its relation to dyspepsia in a population from the western Amazon region. During the "Projeto Bandeira Científica", a University of São Paulo Medical School program, in Monte Negro's rural areas, state of Rondônia, 266 blood samples were collected from volunteers. The material was tested for IgG antibodies anti-Helicobacter pylori by ELISA method and the participants were also interviewed on dyspepsia, hygiene and social aspects. Participants aged between five and 81 years old (34 years on average), 149 (56%) were female and 117 (44%) male. We found 210 (78.9%) positive, 50 (18.8%) negative and six (2.3%) undetermined samples. Dyspeptic complaints were found in 226 cases (85.2%). There was no statistical association between dyspepsia and positive serology for H. pylori. We concluded that the seroprevalence in all age categories is similar to results found in other studies conducted in developing countries, including those from Brazil. On the other hand, the seroprevalence found in Monte Negro was higher than that reported in developed countries. As expected, there was a progressive increase in the positivity for H. pylori in older age groups.

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Effects of Oral Vaccination and Immunomodulation by Cholera Toxin on Experimental Helicobacter pylori Infection, Reinfection, and Gastritis

Infection and Immunity ◽

10.1128/iai.70.8.4621-4627.2002 ◽

2002 ◽

Vol 70 (8) ◽

pp. 4621-4627 ◽

Cited By ~ 42

Author(s):

S. Raghavan ◽

A.-M. Svennerholm ◽

J. Holmgren

Keyword(s):

Helicobacter Pylori ◽

Cholera Toxin ◽

Mononuclear Cells ◽

Oral Treatment ◽

Bacterial Load ◽

Oral Immunization ◽

Initial Infection ◽

Fold Reduction ◽

H Pylori

ABSTRACT Therapeutic vaccination is an attractive strategy to control infection and disease caused by Helicobacter pylori. In mice infected with H. pylori we have studied the protective effect of oral immunization with an H. pylori lysate preparation given together with the mucosal adjuvant cholera toxin (CT), both against the initial infection and against a later reinfection challenge. We have also examined the effects of treatment with the CT adjuvant alone on H. pylori infection and reinfection. Specific immunization with lysate was found to result in a sixfold reduction of the extent (bacterial load) of the primary infection and also to provide similar levels of protection against reinfection. However, these effects were associated with severe postimmunization gastritis. In contrast, oral treatment with CT alone at the time of initial infection, while unable to suppress the initial infection, gave rise to a 20-fold reduction in bacterial load upon reinfection without causing any associated gastric inflammation. Both the infected animals that were specifically immunized and those that were treated with CT only displayed increased in vitro proliferative responses of mononuclear cells to H. pylori antigens. Antibody levels in response to H. pylori were on the other hand only marginally increased after treatment with CT, whereas they were markedly elevated after immunization with lysate plus CT, with a rise in both (Th2-driven) immunoglobulin G1 (IgG1) and, especially, (Th1-driven) IgG2a antibodies. The results illustrate the complex balance between protection and harmful inflammation after postinfection vaccination against H. pylori as studied in a mouse model.

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Prevalence of Helicobacter pylori infection among patients undergoing upper gastrointestinal endoscopy

Asian Journal of Health Sciences ◽

10.15419/ajhs.v3i1.405 ◽

2015 ◽

Vol 3 (1) ◽

Author(s):

Vudumula Vijaya Lakshmi

Keyword(s):

Duodenal Ulcer ◽

Helicobacter Pylori ◽

Normal Population ◽

Gastric Ulcers ◽

Upper Gastrointestinal Endoscopy ◽

Contributing Factors ◽

Duodenal Ulcers ◽

Female Ratio ◽

Ulcer Disease ◽

H Pylori

Helicobacter pylori (H. pylori) has a role in the multifactorial etiology of peptic ulcer disease. A link between H. pylori infection and duodenal ulcer disease is now established. Other contributing factors and their interaction with the organism may initiate the ulcerative process. The fact that eradication of H. pylori infection leads to a long-term cure in the majority of duodenal ulcer patients and the fact that the prevalence of infection is higher in ulcer patients than in the normal population are cogent arguments in favor of it being the primary cause of the ulceration. This study was under taken at the Department of surgery, Narayana medical college, Nellore from January 2007 to July 2008. A total of 150 patients with duodenal ulcers, gastric ulcers, antral gastritis, gastric carcinoma and dyspepsia of any kind were studied. Maximum number of cases were in the age group of 31 years to 50 years among both sexes and number of cases gradually decreased after 50 years of age in males and females. Males were more in number and male to female ratio is (2.75:1) approximately 3:1.

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