CLINICAL, ENDOSCOPIC AND PATHOLOGICAL RESPONSES AFTER ERADICATION WITH RACM REGIMEN IN PATIENTS OF HELICOBACTER PYLORI-RELATED CHRONIC GASTRITIS

2016 ◽  
pp. 12-19
Author(s):  
Thi Hoai Thai ◽  
Van Huy Tran
Keyword(s):  
Helicobacter Pylori ◽  
Intestinal Metaplasia ◽  
Chronic Gastritis ◽  
Clinical Symptoms ◽  
Epigastric Pain ◽  
Bile Reflux ◽  
Helicobacter Pylori Eradication ◽  
Significant Change ◽  
H Pylori ◽  
Active Inflammation

Background: The clinical, endoscopic and histopathological responses after Helicobacter pylori eradication in patients of chronic gastritis were still inconstant. This study is aimed at: (1) evaluating of clinical variations, endoscopic images six months after Helicobacter pylori eradication by Rabeprazole-Amoxicillin—Metronidazole-Clarithromycin therapy for 14 days. (2) assessing histopathological response six months after H. pylori eradication. Method: prospective, consisting of 83 patients examined and treated in Danang hospital from 4/2014 to 6/2015. Results: There were improvements in clinical symptoms 6 months after H. pylori eradication: epigastric pain 85.5% vs. 7.2%); bloating (97.1% vs. 4.3%); indigestion (47.8% vs. 2.9%); weight loss (17.4% vs. 1.4%); anorexia (23.2% vs. 2.9%) (p< 0.01). However, there were no improvement regarding common lesions on endoscopy, edema (33.3% increase to 71%); flat erosion and elevated erosion (15.9% vs. 8.7%); atrophy (7.2%); haemorrhagic (5.8% vs. 0%); hypertrophic (7.2% vs. 0%); bile reflux (14.5% vs. 4.3%). Regarding histopathology: active inflammation accounted for a high proportion (63.8% vs. 27.5%); non-active inflammation (36.2% increase to 72.5%); atrophy (8.7% vs. 5.8%); dysplasia (26.1% vs. 1.4%), no significant change in intestinal metaplasia was found after treatment. Conclusions: There was an improvement in clinical symptoms and histopathological against inflammatory activity grade, dysplasia at the time before and after 6 months treatment H. pylori eradication. However, no significant change in mucosal atrophy and intestinal metaplasia was found. Key words: chronic gastritis; H. pylori; clinical, endoscopic and pathological responses

scholarly journals Effects of cinnamon extract on complications of treatment and eradication of Helicobacter pylori in infected people

2020 ◽  
Vol 9 (1) ◽  
pp. 55-60
Author(s):  
Ghazal Imani ◽  
Alireza khalilian ◽  
Dara Dastan ◽  
Behzad Imani ◽  
Maryam Mehrpoya
Keyword(s):  
Helicobacter Pylori ◽  
Drug Treatment ◽  
Clinical Symptoms ◽  
Epigastric Pain ◽  
Control Group ◽  
Blurred Vision ◽  
Infected People ◽  
Cinnamon Extract ◽  
H Pylori ◽  
Metallic Flavor

Introduction: Treatment of Helicobacter pylori has various side effects like antibiotic resistance. The purpose of this study was to evaluate the effects of cinnamon extract on complications of treatment and eradication of H. pylori in infected people. Methods: In this randomized clinical trial, a total of 98 eligible healthy and H. pylori-infected patients approved by esophageal endoscopy were selected. The cinnamon group received multi-drug treatment including clarithromycin, amoxicillin and pantoprazole as well as a cinnamon extract capsule. The control group received multi-drug treatment and a 40 mg starch capsule. In order to analyze the cinnamon extract efficacy, the urea breath test (UBT) was performed 3 months after the start of treatment. Clinical symptoms were evaluated by a questionnaire at the beginning (day of 0), 7 days and 14 days after starting treatment. Results: The clinical symptoms such as nausea, vomiting, diarrhea, constipation, blurred vision, headache, metallic flavor, epigastric pain, burp, and appetite were significantly reduced in the cinnamon group (P < 0.05). The odds ratio exhibited a higher eradication rate of H. pylori in the cinnamon group (73.47% in the cinnamon group compared to 53.06% in the control group) (P = 0.036). Conclusion: Cinnamon as assisted therapy is able to alleviate the disease and reduce the complications of H. pylori treatment.

EFFICACY OF RACM REGIMEN ON HELICOBACTER PYLORI ERADICATION IN PATIENTS OF CHRONIC GASTRITIS

2016 ◽  
pp. 88-93
Author(s):  
Thi Hoai Thai ◽  
Van Huy Tran
Keyword(s):  
Helicobacter Pylori ◽  
Side Effects ◽  
Chronic Gastritis ◽  
Eradication Rate ◽  
Statistical Significance ◽  
Rapid Urease Test ◽  
Antibiotic Resistant ◽  
Helicobacter Pylori Eradication ◽  
Urease Test ◽  
H Pylori

Background: H. pylori eradication still remains a challenge to clinicians, especially with the increasing antibiotic-resistant H. pylori. Concomitant therapy showed effective, even in some multiresistant population, but data in Vietnam is still very limited. The study ''Study of Helicobacter pylori eradication with RACM regimen in chronic gastritis patients at Da Nang Hospital from 1/4/2014 to 30/6/2015, is aimed at: (1) Evaluating the results of Helicobacter pylori eradication of Amoxicillin-Clarithromycin-Rabeprazole-Metronidazole therapy for 14 days.(2) Assessing some side effects of this regimen.Method: prospective, consisting of 83 patients examined and treated in Danang hospital from1/ 4/2014 to 30/6/2015, H.pylori was tested by rapid Urease test; H.pylori positive patients received RACM for 14 days. Results: H.pylori eradication rate was 83.1%. H. pylori eradication rates in different locations: antrum 63.8%, higher than corpus (17.4%), antrum and corpus (18.8%), with statistical significance at p<0.05. Common side effects was nausea (27.7%), diarrhea (19.3%). Abdominal pain, lightheadedness, dizziness, insomnia, headache account for low percentage: 8%; 6%; 3,6% and 2.4% respectively. Conclusion: The effect of 14 day RACM regimen for H. pylori eradication was 83.1%, common side effects are nausea (27.7%), diarrhea (19.3%). Key words: chronic gastritis;H. pylori; eradication of H. pylori(ITT); RACM regimen.

EFFICACY OF HYBRID THERAPY (RA-RACM) IN PATIENTS WITH HELICOBACTER PYLORI POSITIVE-CHRONIC GASTRITIS

2015 ◽  
pp. 17-23
Author(s):  
Thanh Van Nguyen ◽  
Van Huy Tran
Keyword(s):  
Adverse Effects ◽  
Atrophic Gastritis ◽  
Intestinal Metaplasia ◽  
Chronic Gastritis ◽  
Eradication Rate ◽  
Clinical Symptoms ◽  
Epigastric Pain ◽  
Upper Gastrointestinal Endoscopy ◽  
Hybrid Therapy ◽  
Hybrid Regime

Objectives: To evaluate the efficacy and adverse effects of hybrid regime in patients with chronic gastritis patients H.pylori positive. Subjects and methods: A prospective cross-sectional study was conducted on 189 chronic gastritis patients at Cho Ray Hospital, from 25/09/2013 to 29/07/2014. All patients underwent upper gastrointestinal endoscopy and biopsy to perform CLO Test and analyse histo-pathological. 92 patients H.pylori with CLO test positive were enrolled in the therapy with hybrid therapy RA-RACM. Results: 92 patients with positive H.pylori (36 males and 56 females), the mean age of population study was 41.65 ± 11.69. The percentage of H.pylori infection was 48.7. The eradication rate of H.pylori was 88.0%. In general, comparison of before and after eradication, the prevalence of epigastric pain was 89.1% vs. 69.1%, delayed gastric empty and sour reflux and the other clinical symptoms were 61.9% vs. 30.8%, 46.7% vs. 30.8% and 31.5% vs. 4.9%, respectively (p < 0.05). Endoscopically, after H.pylori eradication: congestive antritis (from 53.2% to 63.1%), raised erosion (from 15.2% to 14.1%), flat erosion (from 31.5% to 22.8%) (p > 0.05). Histopathology, before H.pylori eradication: Antral active gastritis (61.9%), atrophic gastritis (13.0%), intestinal metaplasia (6.5%), dysplasia (5.4%). Corpus active gastritis (59.8%), atrophic gastritis (5.4%), intestinal metaplasia (2.2%), dysplasia (4.3%); (p> 0.05). Most of lesions were mild. The rate of H.pylori infection in antrum (33.9%), and in corpus (28.0%). The most common adverse effects were 70.6%, mainly bitter taste, none of patients was excluded. Conclusions: The eradication rate of hybrid regime (RA-RACM) is high; the side effects were rare and relatively mild. Hybrid therapy may be considered as a first line of H.pylori treatment in current clinical practice. Key words: Chronic gastritis, hybrid regime (RA-RACM), H.pylori

Cell Proliferation and Inflammation on Biopsy Samples With Multifocal Atrophic Gastritis Before and 1 Year After Helicobacter pylori Eradication

2005 ◽  
Vol 129 (11) ◽  
pp. 1451-1456
Author(s):  
Jeannette Guarner ◽  
Jeanine Bartlett ◽  
Roslyn Seitz ◽  
Toni Whistler ◽  
Roberto Herrera-Goepfert ◽  
...  
Keyword(s):  
Cell Proliferation ◽  
Helicobacter Pylori ◽  
T Lymphocytes ◽  
Intestinal Metaplasia ◽  
Eradication Therapy ◽  
Ki 67 ◽  
Proliferation Markers ◽  
Helicobacter Pylori Eradication ◽  
Biopsy Specimens ◽  
H Pylori

Abstract Context.—Results of clinical trials that have assessed whether gastric cancer is preventable with Helicobacter pylori eradication therapy remain inconclusive. These trials have used atrophy, intestinal metaplasia, and dysplasia as histopathologic end points that reflect possible preneoplastic lesions. Trial results would be more compelling if cell proliferation and inflammatory markers improved simultaneously with histopathologic lesions. Objective.—To study the presence of cell proliferation markers and type of inflammatory cells in biopsy specimens with gastritis, atrophy, and intestinal metaplasia before and 1 year after H pylori therapy and to determine if immunohistochemistry can be used to study these. Design.—We evaluated 12 subjects with gastritis and 16 with gastritis and multiple foci of atrophy and intestinal metaplasia by using immunohistochemical assays for tumor suppressor protein p53, proliferation marker Ki-67, cell cycle regulator cyclin D1, T and B lymphocytes, macrophages, and TUNEL (terminal deoxynucleotide transferase deoxyuridine triphosphate nick end labeling) assay for apoptosis. The biopsy specimens were selected from a randomized clinical trial that studied improvement of histopathologic gastric lesions after H pylori eradication. Results.—Groups of surface epithelial cells that expressed p53 and Ki-67 were observed more often in subjects with atrophy and intestinal metaplasia compared with those with gastritis alone. T lymphocytes in the lamina propria were frequently observed 1 year after treatment in subjects with atrophy and intestinal metaplasia. Conclusions.—Immunohistochemical assays for cell proliferation and inflammatory cell markers showed different distribution patterns in these gastric biopsy specimens. The presence of T lymphocytes and groups of cells that expressed proliferation markers in subjects with multiple foci of atrophy and intestinal metaplasia needs further study.

scholarly journals A case of Helicobacter pylori-negative early gastric adenocarcinoma with gastrointestinal phenotype

2021 ◽  
Vol 09 (06) ◽  
pp. E863-E866
Author(s):  
Masafumi Takatsuna ◽  
Rie Azumi ◽  
Takeshi Mizusawa ◽  
Hiroki Sato ◽  
Ken-Ichi Mizuno ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Helicobacter Pylori ◽  
Intestinal Metaplasia ◽  
Bile Reflux ◽  
Tumor Lesion ◽  
Mucosal Layer ◽  
History Of ◽  
Well Differentiated ◽  
Mucosal Glands ◽  
H Pylori

AbstractA 40-year-old man with slightly depressed (0-IIc) type gastric cancer of the pyloric anterior gastric area underwent pre-operative screening for tetralogy of Fallot and endoscopic submucosal dissection (ESD) and was tested for Helicobacter pylori antigens and antibodies. Both tests were negative. He did not have a history of eradication. Pathological diagnosis of ESD showed a well-differentiated adenocarcinoma. The tumor was CD10-positive, MUC5AC-negative, and MUC6-confocal positive; it showed differentiation with gastrointestinal phenotype. Moreover, the tumor cells were lysozyme-positive, resembling Paneth cells. Mucosal glands exhibited intestinal metaplasia on the anal side of the tumor lesion. On the oral side of the tumor, metaplasia was non-existent, with normal pyloric glands present in the mucosal layer. The patient was not infected with H. pylori; however, intestinal metaplasia existed around the early gastric cancer. This suggested that the intestinal metaplasia occurred due to bile reflux, and the gastric neoplasia arose with the metaplasia without an H. pylori infection. This case may potentially help explain gastric cancer development in the absence of H. pylori infection.

scholarly journals Significance of Helicobacter pylori Eradication on Atrophic Gastritis and Intestinal Metaplasia

2020 ◽  
Vol 20 (2) ◽  
pp. 107-116
Author(s):  
Kichul Yoon ◽  
Nayoung Kim
Keyword(s):  
Helicobacter Pylori ◽  
Atrophic Gastritis ◽  
Intestinal Metaplasia ◽  
Precancerous Lesions ◽  
Eradication Therapy ◽  
Diffuse Type ◽  
Helicobacter Pylori Eradication ◽  
Predicting Factors ◽  
Point Of No Return ◽  
H Pylori

There has been an accumulation of data regarding the chemopreventive effects of <i>Helicobacter pylori</i> (<i>H. pylori</i>) eradication. However, it remains unclear how <i>H. pylori</i> infection causes gastric cancer (GC) and how <i>H. pylori</i> eradication can prevent GC. Atrophic gastritis (AG) and intestinal metaplasia (IM) are known as precancerous lesions which mainly lead to intestinal-type GC but to some extent, can also lead to diffuse-type GC. The most important mechanism of AG/IM is <i>H. pylori</i>-induced chronic gastritis. Thus, the reversibility of AG and IM by <i>H. pylori</i> eradication therapy is very important in the prevention of GC. There have been many studies providing data supporting the improvement of AG by the eradication of <i>H. pylori</i> to some extent. In contrast, IM has been regarded as “the point of no return.” However, more recent studies have implied the improvement of IM after eradication, suggesting the importance of early eradication therapy in reversible histological status. In this review, we focused on the reversibility of AG and IM by <i>H. pylori</i> eradication and tried to investigate the predicting factors for the improvement of AG and IM including age, sex, smoking, and diet, as well as <i>H. pylori</i> infection.

scholarly journals Association of Helicobacter pylori vacA polymorphisms with the risk of gastric precancerous lesions in a Moroccan population

2021 ◽  
Vol 15 (08) ◽  
pp. 1124-1132
Author(s):  
Mohamed Reda Jouimyi ◽  
Ghizlane Bounder ◽  
Imane Essaidi ◽  
Hasna Boura ◽  
Wafaa Badre ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
High Risk ◽  
Atrophic Gastritis ◽  
Intestinal Metaplasia ◽  
Chronic Gastritis ◽  
Precancerous Lesions ◽  
Gastric Lesions ◽  
D Region ◽  
Reliable Marker ◽  
H Pylori

Introduction: Helicobacter pylori infection is the major risk factor of atrophic gastritis and intestinal metaplasia. The vacA gene is one of the most virulence factors of H. pylori and genetic diversity in its s, m, i, and d regions is associated with gastric lesions severity. This study aimed to investigate the association of vacA s, m, i, and d regions with the risk of atrophic gastritis and intestinal metaplasia in a Casablanca population. Methodology: A total of 210 patients suffering from gastric lesions (chronic gastritis, atrophic gastritis, and intestinal metaplasia) were enrolled. The type of lesion was diagnosed by histological examination. Detection of H. pylori infection and genotyping of vacA regions were carried out by PCR. Results: The prevalence of H. pylori was 95%. The most common vacA genotypes were s2 (51.5%), m2 (77%), i2 (60.5%), and d2 (58.5%). VacA s1, m1, and i1 genotypes were associated with a high risk of intestinal metaplasia, while the vacA d1 genotype increases the risk of atrophic gastritis and intestinal metaplasia. The most common vacA combination was s2/m2/i2/d2 (52%), and it was more detected in chronic gastritis. The moderate virulent vacA combination (s1/m2/i1/d1) increases the risk of atrophic gastritis, while the most virulent vacA combination (s1/m1/i1/d1) increases the risk of intestinal metaplasia. Conclusions: Genotyping of vacA d region might be a reliable marker for the identification of vacA virulent strains that represent a high risk of developing precancerous lesions (atrophic gastritis and intestinal metaplasia).

Practical Approach to the Pathologic Diagnosis of Gastritis

2008 ◽  
Vol 132 (10) ◽  
pp. 1586-1593 ◽  
Author(s):  
Antonia R. Sepulveda ◽  
Madhavi Patil
Keyword(s):  
Helicobacter Pylori ◽  
Chronic Gastritis ◽  
Bile Reflux ◽  
Practical Approach ◽  
Pathologic Diagnosis ◽  
Gastrointestinal Pathology ◽  
Data Source ◽  
H Pylori ◽  
Hematoxylin Eosin ◽  
Immunohistochemical Stains

Abstract Context.—Most types of gastritis can be diagnosed on hematoxylin-eosin stains. The most common type of chronic gastritis is Helicobacter pylori gastritis. Reactive or chemical gastropathy, which is often associated with nonsteroidal anti-inflammatory drug use or bile reflux, is common in most practices. The diagnosis of atrophic gastritis can be challenging if few biopsy samples are available and if the location of the biopsies in the stomach is not known, such as when random biopsies are sampled in one jar. If the biopsy site is not known, immunohistochemical stains, such as a combination of synaptophysin and gastrin, are useful in establishing the biopsy location. Objective.—To demonstrate a practical approach to achieving a pathologic diagnosis of gastritis by evaluating a limited number of features in mucosal biopsies. Data Source.—In this article, we present several representative gastric biopsy cases from a gastrointestinal pathology practice to demonstrate the practical application of basic histopathologic methods for the diagnosis of gastritis. Conclusions.—Limited ancillary tests are usually required for a diagnosis of gastritis. In some cases, special stains, such as acid-fast stains, and immunohistochemical stains, such as for H pylori and viruses, can be useful. Helicobacter pylori immunohistochemical stains can particularly contribute (1) when moderate to severe, chronic gastritis or active gastritis is present but no Helicobacter organisms are identified upon hematoxylin-eosin stain; (2) when extensive intestinal metaplasia is present; and (3) in follow-up biopsies, after antibiotic treatment for H pylori.

A Case of Cap Polyposis Remission by Betamethasone Enema aer Antibiotics erapy including Helicobacter pylori Eradication

2014 ◽  
Vol 23 (2) ◽  
pp. 203-206 ◽  
Author(s):  
Hideo Suzuki ◽  
Masashi Sato ◽  
Daisuke Akutsu ◽  
Hiroaki Sugiyama ◽  
Taiki Sato ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Clinical Symptoms ◽  
Laboratory Data ◽  
Pathological Examination ◽  
Helicobacter Pylori Eradication ◽  
Endoscopic Findings ◽  
Cap Polyposis ◽  
H Pylori ◽  
Subsequent Administration ◽  
Crypt Cells

We report the case of a 58-year-old woman who was referred to our hospital due to frequent bloody mucus diarrhea. She was diagnosed with cap polyposis based on typical endoscopic and histological findings. Colonoscopy revealed multiple, reddish, mucus-capped polypoid lesions from the rectum to the sigmoid colon. A pathological examination revealed that the polyps were covered by erosive and inflamed granulation tissue with decreased crypt cells. Laboratory data indicated positive values for Helicobacter pylori immunoglobulin G antibody and hypoproteinemia. Metronidazole, H. pylori eradication, and levofloxacin therapies were not effective; however, the subsequent administration of betamethasone enema dramatically improved the clinical symptoms and endoscopic findings. The hypoproteinemia was normalized after the therapy. The dose of the betamethasone enema was tapered gradually, and no recurrence was observed 6 months after discontinuation of the treatment. This case suggests that betamethasone enema may be considered as the second treatment choice for cap polyposis patients after H. pylori eradication, metronidazole or levofloxacin therapy.

EFFICACY OF MODIFIED BISMUTH QUADRUPLE THERAPY (RBMA) AS FIRST-LINE THERAPY FOR ERADICATION OF HELICOBACTER PYLORI IN PATIENTS WITH CHRONIC GASTRITIS

2019 ◽  
pp. 28-32
Author(s):  
Van Huy Tran
Keyword(s):  
Helicobacter Pylori ◽  
Adverse Effects ◽  
Chronic Gastritis ◽  
Eradication Rate ◽  
High Rate ◽  
First Line ◽  
Helicobacter Pylori Eradication ◽  
Quadruple Therapy ◽  
First Line Therapy ◽  
Line Therapy

Background and aims: Efficacy with substitution of tetracycline with amoxicillin, an antibiotics having a very low resistance rate and a high tolerability, in bismuth quadruple therapy (BQT) have not been studied in Vietnam. Our study aimed to evaluate the efficacy and tolerability of modified BQT vs. standard BQT for first-line Helicobacter pylori eradication. Patients and methods: This is a randomized, prospective study. 120 patients with H.pylori positive-chronic gastritis were randomly divided into two groups. The RBMA group containing rabeprazole 20 mg, bismuth subsalicylic 524mg, metronidazole 500mg, amoxicillin 1000mg, all 2 times a day, for 14 days. The RBMT group received rabeprazole, bismuth subsalicylic, metronidazole and tetracycline. Evaluation for compliance and drug-related side effects were evaluated at the end of two weeks. 4-6 weeks after the end of treatment, the H.pylori eradication rate was determined by the C13urease breath test. Results: Eradication rate was not statistically significative different between the RBMA and the RBMT: 91.2%; 95% confidence interval, 78.2% - 96.7%) vs. 90%; 95% CI, 81.6% - 96.3%) by per-protocol analysis (p = 0.42) and 86.7% (95%CI, 75.84% - 93.09%) vs. 75% (95%CI, 62.1% - 85.3%) by intention-to-treat analysis (ITT, p = 0.06). Adverse effects were significant higher in the RBMT group than in the RBMA group (48.3% vs. 26.7%; p = 0.071) and rate of good compliance was significantly higher in RBMA group than in RBMT group (p < 0.05). Conclusion: The modified BQT including rabeprazole, bismuth, metronidazole and amoxicillin achieved a fairly high rate of H.pylori infection eradication with a higher compliance and lower rate of adverse effects compared to the BQT in patients with chronic gastritis. Further studies need to conduct to confirm this new regimens as a first-line therapy in our country. Key words: Modified bismuth quadruple therapy, BQT, Helicobacter pylori eradication

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