CHRONIC GASTRITIS AND OLD AGE: A PROBLEM OR NOT?

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.

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Guality eradication anti-helicobacter therapy increases the effectiveness of treatment of patients with stable angina pectoris

Experimental and Clinical Gastroenterology ◽

10.31146/1682-8658-ecg-186-2-41-46 ◽

2021 ◽

pp. 41-46

Author(s):

M. N. Prikhodko ◽

Zh. G. Simonova ◽

E. P. Kolevatykh

Keyword(s):

Chronic Gastritis ◽

Clinical Status ◽

Eradication Therapy ◽

Antibiotic Sensitivity ◽

Prospective Clinical Study ◽

Group I ◽

Group Ii ◽

H Pylori ◽

Gastroduodenal Zone ◽

Endoscopic Picture

Aim. On the basis of the complex analysis, to evaluate the efficiency of eradication therapy at patients with stable stenocardia with a combination of chronic gastritis. Material and methods. 46 patients with stable stenocardia with a combination of chronic H. pylori-associated gastritis were included in the open prospective clinical study. Two groups of patients were formed during the study. Patients of group I (n = 25) received eradication therapy in accordance with antibiotic sensitivity of H. pylori strains, patients of group II (n = 21) - without antibiotic sensitivity. In all patients before and after treatment were performed: evaluation of clinical status, laboratory indicators, EGDS with biopsy sampling, diagnosis of H. pylori. Results. The effectiveness of eradication therapy was 86.9%, at the same time, 96% -in group I and 76.2% - in group II. It is established: stabilization of clinical status of patients, improvement of morphological and endoscopic picture of gastroduodenal zone, improvement of laboratory indices. Conclusions. The inclusion of antibiotic-sensitive erication therapy in the algorithm of treatment of patients with stable stenocardia in combination with chronic gastritis allows to achieve high effectiveness of killing the infection Helicobacter pylori. At the same time stabilizes clinical status of patients, laboratory indices, has a positive effect on morphological and endoscopic picture of gastroduodenal zone, preventing progression of metaplastic changes.

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Chronic gastritis and Helicobacter pylori in digestive form of Chagas' disease

Revista do Instituto de Medicina Tropical de São Paulo ◽

10.1590/s0036-46651993000200002 ◽

1993 ◽

Vol 35 (2) ◽

pp. 117-121 ◽

Cited By ~ 9

Author(s):

A. J. A. Barbosa ◽

D. M. M. Queiroz ◽

A. M. M. F. Nogueira ◽

M. J. A. Roquette Reis ◽

E. N. Mendes ◽

...

Keyword(s):

Helicobacter Pylori ◽

Gastric Mucosa ◽

Atrophic Gastritis ◽

Chagas Disease ◽

Chronic Gastritis ◽

Antral Mucosa ◽

Common Cause ◽

Superficial Gastritis ◽

H Pylori ◽

Inflammatory Changes

Patients with the digestive form of Chagas'disease frequently present chronic gastritis. As the microorganism Helicobacter pylori is now accepted as the most common cause of human chronic gastritis, the present work was undertaken to verify a possible relationship between the presence of this bacterium and inflammatory changes of antral mucosa in chagasic patients. Seventeen chagasics, with megaesophagus and or megacolon were studied. Fragments from two different regions of antral mucosa were obtained by endoscopy, fixed in 4% neutral formaldehyde and embedded in paraffin. The sections were stained by haematoxylin and eosin for histology analysis, and by carbolfuchsin for H. pylori identification. H. pylori was found in 16 (94.1%) chagasic patients, all of them presenting chronic gastritis. Superficial gastritis was seen in 9 (52.9%) while atrophic gastritis was present in 8 (47.1%) patients. H. pylori was present on gastric mucosa of 8 (100%) patients with atrophic gastritis and of 8 (88.8%) patients with superficial gastritis. We concluded that the microorganism H. pylori should be considered a possible factor connected with the etiopathogenesis of chronic superficial and atrophic gastritis frequently observed in patients with the digestive form of Chagas' disease.

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

BMC Gastroenterology ◽

10.1186/s12876-021-02027-6 ◽

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.

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CHRONIC HELICOBACTER PYLORI GASTRITIS: THE ERADICATION EFFICACY&NBSP;OF THE&NBSP;BISMUTH-CONTAINING QUADRUPLE REGIMEN (EBMT)

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2016.2.21 ◽

2016 ◽

pp. 149-158

Author(s):

Ngoc Quy Hue Dang ◽

Van Huy Tran ◽

Thanh Hai Nguyen

Keyword(s):

Helicobacter Pylori ◽

Side Effects ◽

Chronic Gastritis ◽

Medication Compliance ◽

Compliance Rate ◽

Eradication Therapy ◽

Rapid Urease Test ◽

Urease Test ◽

H Pylori ◽

Helicobacter Pylori Gastritis

Background: there has not been yet any research on the effectiveness of H. pylori eradication of bismuth-containing quadruple regimen on chronic gastritis patients in our country. Objective: to evaluate H. pylori eradication rate of bismuth-containing quadruple regimen according to intention to treat (ITT), per protocol (PP) analysis, the rate of side effects and medication compliance. Subjects and Methods: from March 2014 to January 2016 we used bismuth-containing quadruple regimen (EBMT) 10 days for H. pylori eradication therapy for 166 chronic gastritis patients diagnosed based on clinical, endoscopic, rapid urease test, histology and culture. Patients were evaluated side effects and medication compliance at the end of treatment (day 11-14). To assess the eradication, repeating endoscopy with both rapid urease test and histological examination were performed at 4 to 8 weeks after stopping treatment course. Results: H. pylori eradication rates on ITT and PP analysis overall, for naïve patients, after one and more two eradication failures were respectively: 80.72-89.33%, 79.51-90.65%, 91.67-91.67% and 75.00-78.95%. Medication adherence rate was 96.99%. The rates of patients experiencing moderate, severe and very severe side effects were: 19.88%, 0.60% and 1.81%. Conclusion: the EBMT 10-day regimen attained high eradication rates in chronic gastritis patients with rare serious side effects and the high compliance rate. We should apply bismuth-containing quadruple regimen in H. pylori eradication therapy for naïve patients or after one eradication failure. Key words: bismuth-containing quadruple regimen, EBMT, eradication, chronic Helicobacter pylori gastritis

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Results of the inclusion of osteopathic correction in the complex therapy of patients with chronic gastritis

Russian Osteopathic Journal ◽

10.32885/2220-0975-2021-1-80-89 ◽

2021 ◽

pp. 80-89

Author(s):

R. T. Fazlyakhmetov ◽

R. R. Saﬁullin ◽

A. V. Ustinov

Keyword(s):

Helicobacter Pylori ◽

Gastric Mucosa ◽

Chronic Gastritis ◽

Eradication Therapy ◽

Clinical Manifestations ◽

Integrated Approach ◽

Main Group ◽

Control Group ◽

Study Results ◽

Complex Therapy

Introduction. Many key questions regarding the etiology, pathogenesis, clinical manifestations and treatment of chronic gastritis remain open. So, despite the success of chronic gastritis pharmacotherapy, much attention is paid to non-drug methods of therapy, in particular, osteopathy. However, evidences of the osteopathic methods effectiveness for the chronic gastritis treatment, obtained by objective instrumental methods, are insufﬁciently presented in the modern literature.The goal of research — to study the results of osteopathic correction inclusion in the complex therapy of patients with chronic gastritis.Materials and methods. The study involved 50 patients with chronic gastritis, divided by simple randomization into a control group (25 people) and a main group (25 people). The participants in the control group received standard eradication therapy according to a three-component scheme. The participants of the main group additionally received osteopathic correction. In both groups, at the beginning and at the end of the study, there were performed ﬁbroesophagogastroduodenoscopy with targeted biopsy to assess the gastric mucosa state, Helicobacter pylori identiﬁcation, and intragastric pH-metry to assess gastric juice acidity.Results. According to the study results, a statistically signiﬁcant (p<0,05) decrease in edema and hyperemia of gastric mucosa was found in the control and main groups. There was a statistically signiﬁcant (p<0,001) decrease in gastric aciditywith osteopathic accompaniment, compared with unaccompanied drug treatment. In both groups, there was a statistically signiﬁcant (p<0,05) decrease in the incidence of Helicobacter pylori carriage. Conclusion. Based on the obtained results, it can be assumed that an integrated approach using osteopathic correction in the treatment of chronic gastritis may be more effective than the standard course of treatment.

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CLINICAL AND MORPHOLOGICAL CHARACTERISTICS OF H. PYLORI-ASSOCIATED GASTRODUODENAL ZONE DISEASES: AGE-RELATED ASPECTS

Ulyanovsk Medico-biological Journal ◽

10.34014/2227-1848-2021-4-89-99 ◽

2021 ◽

pp. 89-99

Author(s):

E.M. Shul'gina ◽

Zh.G. Simonova

Keyword(s):

Helicobacter Pylori ◽

Clinical Picture ◽

Average Length ◽

Eradication Therapy ◽

Young Patients ◽

Morphological Characteristics ◽

Prospective Clinical Study ◽

Age Related ◽

H Pylori ◽

Gastroduodenal Zone

The aim of the paper is to study the clinical and morphological characteristics of H. pylori-associated gastroduodenal zone diseases, depending on patients’ age. Materials and Methods. Three groups of patients of various ages with H. pylori-associated gastroduodenal zone diseases were formed in the course of a prospective clinical study. We studied the clinical picture, and morphological characteristics of the gastroduodenal zone before and after eradication therapy. Average length of the observation period was 172 days. All patients underwent esophagogastroduodenoscopy with biopsy. Results. Severe dyspeptic disorders were diagnosed in all young patients belonging to group 1 (100 %). The dyspeptic index corresponded to a high degree of severity. Morphological changes in the gastric mucosa were more significant in patients with a less pronounced clinical picture (Groups 2 and 3). In group 3, atrophic transformations of the gastric corpus were found in 30.5 %, atrophic transformations of the pylorus – in 11 %, and intestinal metaplasia – in 2.8 % of patients. Unlike young and middle-aged patients with pronounced dyspeptic syndrome, elderly patients were characterized by a low-symptom clinical picture, which was accompanied by morphological gastroduodenal zone transformations with the possible progression. Conclusions. Effective eradication therapy contributes to clinical, endoscopic and morphological remission of the gastroduodenal zone and prevents the progression of the inflammatory cascade. Key words: Helicobacter pylori, gastroduodenal diseases, eradication therapy, age characteristics. Цель исследования – изучить клинико-морфологические особенности H. рylori-ассоциированных заболеваний гастродуоденальной зоны в зависимости от возраста пациентов. Материалы и методы. В процессе проспективного клинического исследования были сформированы три группы пациентов разного возраста, имеющих H. pylori-ассоциированные заболевания гастродуоденальной зоны. Изучали клиническую картину, морфологические особенности гастродуоденальной зоны до и после эрадикационной терапии. Период наблюдения больных составил в среднем 172 дня. Всем пациентам выполнялась ззофагогастродуоденоскопия с биопсией. Результаты. У 100 % пациентов молодого возраста (I группа) установлены выраженные диспепсические расстройства. Диспепсический индекс соответствовал высокой степени тяжести. Для пациентов II и Ш групп при менее выраженной клинической картине морфологические изменения слизистой оболочки желудка оказались более существенны. В старшей группе (Ш группа) атрофические преобразования тела желудка выявлены у 30,5 % пациентов, привратника желудка – у 11 %, кишечная метаплазия – у 2,8 %. В отличие от пациентов молодого и среднего возраста, имеющих выраженный диспепсический синдром, для пациентов пожилого возраста характерна малосимптомная клиническая картина, которая сопровождалась морфологическими преобразованиями гастродуоденальной зоны с возможностью прогрессирования. Выводы. Эффективная эрадикационная терапия способствует достижению клинико-эндоскопической и морфологической ремиссии состояния гастродуоденальной зоны и создает условия для предотвращения прогрессирования воспалительного каскада. Ключевые слова: Helicobacter pylori, заболевания гастродуоденальной зоны, эрадикационная терапия, возрастные особенности.

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Influence of duodenogastric reflux in the gastric mucosa histological changes of rats infected with Helicobacter pylori

Revista do Colégio Brasileiro de Cirurgiões ◽

10.1590/0100-69912016004003 ◽

2016 ◽

Vol 43 (4) ◽

pp. 235-242 ◽

Cited By ~ 3

Author(s):

JOSÉ CARLOS RIBEIRO DE ARAUJO ◽

JORGE JOSÉ DE CARVALHO ◽

HUMBERTO OLIVEIRA SERRA

Keyword(s):

Helicobacter Pylori ◽

Gastric Mucosa ◽

Chronic Gastritis ◽

Partial Gastrectomy ◽

Duodenogastric Reflux ◽

Histological Changes ◽

Positive Correlation ◽

Male Wistar Rats ◽

H Pylori ◽

The One

ABSTRACT Objective: to evaluate the influence of Duodenal reflux in histological changes of the gastric mucosa of rats infected with Helicobacter pylori submitted to pyloroplasty. Methods: after two weeks of acclimation, we infected 30 male Wistar rats with Helicobacter pylori. We randomly divided them into three groups: one submitted to pyloroplasty, another to partial gastrectomy and the third, only infected, was not operated. After six months of surgery, euthanasia was carried out. Gastric fragments were studied by light microscopy to count the number of H. pylori, and to observe the histological changes (gastritis, metaplasia, dysplasia and neoplasia). We confirmed these changes by immunohistochemistry using the molecular markers PCNA and TGF-beta. Results: the animals submitted to pyloroplasty had higher percentage of colonization by H. pylori (median=58.5; gastrectomy=16.5; control=14.5). There was a positive correlation between the amount of H. pylori and the occurrence of chronic gastritis present in the antral fragments. Neoplasia occurred in 40% of rats from the group submitted to pyloroplasty. The staining with PCNA and TGF-ß confirmed the histopathological changes visualized by optical microscopy. Conclusions: the antral region was the one with the highest concentration of H. pylori, regardless of the group. There was a positive correlation between the appearance of benign disorders (chronic gastritis, metaplasia, dysplasia) and cancer in mice infected with H. pylori submitted to pyloroplasty.

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Helicobacter pylori Eradication Therapy - Recent Trend in Research

The Korean Journal of Helicobacter and Upper Gastrointestinal Research ◽

10.7704/kjhugr.2019.0051 ◽

2020 ◽

Vol 20 (3) ◽

pp. 210-217

Author(s):

Heung Up Kim

Keyword(s):

Gastric Cancer ◽

Helicobacter Pylori ◽

Antibiotic Resistance ◽

Gastric Mucosa ◽

Drug Exposure ◽

Eradication Therapy ◽

Dual Therapy ◽

Resistance Rate ◽

H Pylori ◽

Selection Of

It is well known that Helicobacter pylori (H. pylori) can cause peptic ulcer, mucosa-associated lymphoid tissue lymphoma, atrophic gastritis, intestinal metaplasia, and ultimately, gastric cancer. Various studies have proven that H. pylori, which attaches to the gastric mucosa, is the cause of gastric cancer and can be eradicated using appropriate antibiotics. Since 2013, Japan has been carrying out national-led eradication treatment of H. pylori for the whole population. However, as drug exposure increases, the resistance rate to some antibiotics increases, and the pattern of antibiotic resistance varies from region to region. Therefore, the development of individualized antimicrobial therapies has become important since antibiotic resistance to H. pylori eradication is a problem worldwide. To help overcome this, remedies such as selection of antibiotics through susceptibility testing, selection of empirical treatment combinations appropriate for the region, dual therapy with high doses of amoxicillin, and the use of rifabutin or sitafloxacin with low antibiotic resistance have been studied. Potassium-competitive acid blocker has been reported to be more potent in inhibiting acid secretion than proton pump inhibitor, and its role in H. pylori eradication is expected. Drug formulations and regimens that are easy to take are being developed to increase compliance. New treatments such as spraying antibiotics directly to the gastric mucosa are being developed and studied.

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State of lipid peroxidation and antioxidant defense in chronic gastritis associated with Helicobacter pylori-infection in middle-aged males

Russian Journal of Infection and Immunity ◽

10.15789/2220-7619-tso-1234 ◽

2020 ◽

Vol 10 (4) ◽

pp. 741-746

Author(s):

O. V. Smirnova ◽

A. A. Sinyakov ◽

N. M. Titova

Keyword(s):

Lipid Peroxidation ◽

Superoxide Dismutase ◽

Helicobacter Pylori ◽

Gastric Mucosa ◽

Chronic Gastritis ◽

Antioxidant Defense ◽

Host Cells ◽

Gastric Epithelium ◽

Metabolism Enzymes ◽

H Pylori

Helicobacter pylori is the most widespread human pathogen, with prevalence reaching up to 20—40% and 80— 90% of adult infection in developed and developing countries, respectively. Many authors consider this infection as a major factor in the development of gastric cancer. In case of H. pylori infection, free homogeneous oxidation is augmented, that elevates the blood amount of POL products. Hyperproduction of reactive oxygen species stimulates free radical POL, accompanied by membrane destruction, damage to proteins, lipids, and DNA. Thus, the destruction of the intracellular and cell outer membranes occurs resulting in cell death. In diseases associated with H. pylori infection, there is a dysregulation of the lipid peroxidation system — antioxidant defense contributing to inconsistency in the regeneration phases triggering disease progression. The aim of our work was to study indicators of POL (diene conjugates, malonic dialdehyde) and antioxidant protection (AOP) (superoxide dismutase enzymes, catalase) in chronic gastritis and chronic atrophic gastritis associated with H. pylori infection. In patients with CG associated with H. pylori as well as CAG and CAG associated with H. pylori they were featured with increased amount of primary (↑DC) and end TBA-active products of lipid peroxidation (↑MDA), whereas activity of superoxide dismutase was decreased, additionally highlighted with reduced catalase activity (↑CAT) in CAG and CAG associated with H. pylori. H. pylori just triggers the mechanisms of ROS generation in host cells. The energy of redox reactions is used by the microorganism to carry out its physiological functions and serves as a factor in its own pathogenicity, the ROS generated in such reactions can have a damaging effect on the structure of gastric mucosa. In addition, examining H. pylori genome has shown that it bears the genes encoding oxidative metabolism enzymes, such as SOD, catalase, nitroreductase, flavodoxin oxidoreductase. Long-term persistence of H. pylori in the gastric mucosa paralleled with its increased biomass accounts for it being the main source of ROS production able to augment lipid peroxidation and cause damage to the membrane structures and DNA of gastric epithelium cells.

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