LONG-TERM RESULTS OF THERAPY OF H. PYLORI PEPTIC ULCER ASSOCIATED WITH HELICOBACTER PYLORI

Author(s):  
Марина Михайловна Романова ◽  
Алексей Викторович Чернов ◽  
Марина Владиславовна Силютина ◽  
Ольга Николаевна Таранина

Высокая распространенность, постоянный рост заболеваемости, увеличение случаев атипичных форм, числа осложнений, требующих оперативного вмешательства, смертности в связи с новой социально-экономической и экологической обстановкой, колоссальный экономический ущерб, наносимый обществу, ставят язвенную болезнь в ряд важнейших социально-медицинских проблем. В связи с этим одной из задач научной и практической гастроэнтерологии остается изучение этиологии, патогенеза, разработка и совершенствование, оптимизация и удешевление методов диагностики и лечения ЯБ, а также возможности прогнозирования динамики процесса, степени чувствительности к лечению, оценки эффективности последнего. Статья посвящена результатам исследования по ретроспективному анализу течения язвенной болезни после лечения с применением антихеликобактерных схем на основе проведения анкетированного опроса для оценки эффективности отдаленных результатов антихеликобактерной терапии. Полученные данные обрабатывали статистически с помощью программ «Microsoft Excel» 5.0 и «Statistica» 6.0 for Windows. Полученные результаты позволяют сделать выводы о том, продолжение рецидивирования язвенной болезни после применения антихеликобактерной терапии может быть связано с неполной эрадикацией хеликобактер пилори, с повторным реинфицированием, определенную роль могут играть и нарушения вегетативного баланса, как проявление дизадаптационно - регуляторных изменений The high prevalence, constant increase in morbidity, increase in cases of atypical forms, the number of complications requiring surgery, mortality due to the new socio-economic and environmental situation, and the enormous economic damage caused to society, put peptic ulcer disease among the most important socio-medical problems. In this regard, one of the tasks of scientific and practical gastroenterology is to study the etiology and pathogenesis, develop and improve, optimize and reduce the cost of methods for diagnosing and treating YB, as well as the possibility of predicting the dynamics of the process, the degree of sensitivity to treatment, and evaluating the effectiveness of THE latter. The article is devoted to the results of a study on retrospective analysis of the ulcer after treatment of H. pylori schemes through questionnaires survey to assess the effectiveness of remote results of therapy of H. pylori. The obtained data were processed statistically using the programs "Microsoft Excel" 5.0 and "Statistica" 6.0 for Windows. The results obtained allow us to conclude that the continuation of recurrence of ulcerative boseni after the use of anti-Helicobacter pylori therapy may be associated with incomplete eradication of Helicobacter pylori, with repeated reinfection, and a certain role may be played by violations of the vegetative balance, as a manifestation of dysadaptation-regulatory changes

2003 ◽  
Vol 10 (3) ◽  
pp. 148-156 ◽  
Author(s):  
P Roderick ◽  
R Davies ◽  
J Raftery ◽  
D Crabbe ◽  
R Pearce ◽  
...  

Objectives: To evaluate the cost-effectiveness of population screening for Helicobacter pylori in preventing gastric cancer and peptic ulcer disease in England and Wales. Methods: A discrete event simulation model used parameter estimates, derived from peer-reviewed literature, routine data and statistical modelling. Population screening was compared with no screening but with opportunistic eradication in patients presenting with dyspepsia. Costs included screening, eradication and costs averted to provide costs per life years saved (cost/LYSj for preventing gastric cancer and peptic ulcer disease. Sensitivity analyses were undertaken. Results: The cost/LYS from screening at age 40 years was £5860 at discount rates of 6%. The outcomes were sensitive to H. pylori prevalence, the degree of opportunistic eradication, the discount rate, the efficacy of eradication on gastric cancer risk, the risk of complicated peptic ulcer disease and gastric cancer associated with H. pylori infection, and the duration of follow-up. In sensitivity analyses, the cost/LYS rarely exceeded £20000 over an 80-year follow-up, but did for shorter periods. Conclusions: H. pylori screening may be cost-effective in the long term. However, before screening can be recommended further evidence is needed to resolve some of the uncertainties, particularly over the efficacy of eradication on risk of gastric cancer, the risk associated with complicated peptic ulcers, and the effect of more widespread opportunistic testing of patients with dyspepsia.


2006 ◽  
Vol 74 (7) ◽  
pp. 4064-4074 ◽  
Author(s):  
Mónica Oleastro ◽  
Lurdes Monteiro ◽  
Philippe Lehours ◽  
Francis Mégraud ◽  
Armelle Ménard

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.


2019 ◽  
Vol 2 (1) ◽  
pp. 4-10
Author(s):  
Sunit Agrawal ◽  
D Thakur ◽  
P Kafle ◽  
A Koirala ◽  
R K Sanjana ◽  
...  

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.


2016 ◽  
Vol 53 (3) ◽  
pp. 152-155 ◽  
Author(s):  
Yuri Costa Farago FERNANDES ◽  
Gabriel da Rocha BONATTO ◽  
Mauro Willeman BONATTO

ABSTRACT Background Infection with Helicobacter pylori is highly prevalent worldwide, especially in developing countries. Its presence in the gastroduodenal mucosa is related with development of peptic ulcer and other illnesses. The eradication of H. pylori improves mucosal histology in patients with peptic ulcers. Objective This study was aimed to verify if H. pylori recurrence occurs five years or more after confirmed eradication in patients with peptic ulcer. Moreover, we sought to determine the recurrence rate. Methods Retrospective and longitudinal, this study was based on a sample of 201 patients from western Paraná, Brazil. The patients were diagnosed with peptic ulcer disease, in the period of 1990-2000, and followed for five years or more after successful H. pylori eradication. Patients with early recurrence - prior to five years after eradication - were excluded from the sample. Results During an average follow-up of 8 years, 180 patients (89.55%) remained negative, and 21 (10.45%) became positive for H. pylori infection. New ulcers appeared in two-thirds of the patients with H. pylori recurrence. Conclusion The recurrence of H. pylori in patients with peptic ulcer can occur in the long-term - even if the infection had been successfully eradicated and the patients had remained free of recurrence in the first years of follow-up.


1998 ◽  
Vol 4 (3) ◽  
pp. 135-139 ◽  
Author(s):  
Gh. Jeelani Romshoo ◽  
G. M. Malik ◽  
M. Youssuf Bhat ◽  
Ab. Rashid rather ◽  
Javaid Ahmad Basu ◽  
...  

Aim: To study the association of Helicobacter pylori infection with chronic antral gastritis in peptic ulcer disease patients and healthy population of Kashmir.Methods: 50 peptic ulcer patients (duodenal ulcer = 46, gastric ulcer = 2 and combined duodenal and gastric ulcer = 2) and 30 asymptomatic healthy volunteers were included in this study. Peptic ulcer was diagnosed on endoscopic examination. 4–6 punch biopsies were taken from gastric antrum in all the individuals and in case of gastric ulcer an additional biopsy was taken from the edge of the ulcer to exclude its malignant nature. Helicobacter pylori (H. pylori) organism was diagnosed using three different test methods, viz. Histology (using Giemsa Stain), Microbiology (Gram Stain) and Biochemistry (using one minute Endoscopy Room Test). Histological diagnosis of H. pylori was taken as the “gold standard” for the presence of H. pylori organism. Histological diagnosis of gastritis was made using Hematoxylin and Eosin Stain and the gastritis was classified as active chronic gastritis and superficial chronic gastritis.Results: Out of 30 peptic ulcer disease patients with associated antral gastritis, 27 (90%) were positive for H. pylori on histological examination (13 superficial chronic gastritis and 14 active chronic gastritis) whereas out of 8 healthy volunteers with histological evidence of chronic antral gastritis, H. pylori was observed in 7 individuals (87.50%) (4 active chronic gastritis and 3 superficial chronic gastritis).Conclusion: A highly significant association between H. pylori infection with chronic antral gastritis both in peptic ulcer disease patients and healthy volunteers of Kashmir was found in this study. Association between H. pylori infection and chronic gastritis was 90% in peptic ulcer group and 87.50% in healthy population (P<0.005).


2020 ◽  
Vol 7 (6) ◽  
pp. 1908
Author(s):  
Kemparaj T. ◽  
Ashika Bagur

Background: Gastroduodenal perforations constitute one of the commonest surgical emergencies encountered. Helicobacter pylori is a gram negative bacterium that has infected more than half the world’s population. The most commonly recognized manifestation of H. pylori infection in India is peptic ulcer disease. Although the relationship between H. pylori infection and peptic ulcer has been well defined, the relationship of H. pylori infection with gastroduodenal perforation is still controversial. The objective of the study was to determine the presence of H. pylori in gastroduodenal perforations.Methods: We conducted a prospective study, noting the number of cases which turned out to be positive for H. pylori in cases of gastroduodenal perforations intraoperatively, using rapid urease test.Results: Out of 100 cases of gastroduodenal perforations operated, 74% were positive for the test. Gastric perforations positive for the test were 81.4% and duodenal perforations positive for the test were 68.42%.Conclusions: There is a positive attribution between H. pylori infection and gastroduodenal perforations.


1999 ◽  
Vol 37 (4) ◽  
pp. 912-915 ◽  
Author(s):  
Manuela Donati ◽  
Elisa Storni ◽  
Lucia D’Apote ◽  
Sandra Moreno ◽  
Antonio Tucci ◽  
...  

The results of PCR-based molecular typing of Helicobacter pylori strains by restriction fragment length polymorphism analysis of a 1,161-bp nucleotide sequence of the midregion of thevacA gene are reported. A total of 48 H. pylori strains isolated from gastric biopsy specimens obtained from 18 patients with peptic ulcer dyspepsia, 15 patients with nonulcer dyspepsia, and 15 asymptomatic H. pylori-infected subjects were studied. Highly heterogeneous restriction patterns were obtained by digestion of PCR products with SauII,BglII, and HhaI, whereas HaeIII digestion resulted in a strictly homogeneous profile for H. pylori strains isolated from 14 of 18 (77.7%) patients with peptic ulcer dyspepsia, but a strictly homogeneous profile was found for strains from only 8 of 15 (53.3%) patients with nonulcer dyspepsia (P = 0.163) and 5 of 15 (33.3%) asymptomaticH. pylori-infected subjects (P = 0.014). A potentially important aspect of the results obtained is the clinical relevance, since a single restriction pattern seems to be able to identify the majority of H. pylori strains associated with peptic ulcer disease.


2020 ◽  
Vol 15 ◽  
Author(s):  
Nasr Alrabadi ◽  
Iyad S. Albustami ◽  
Husam A. Abuhayyeh ◽  
Khaled M. El-Muwalla ◽  
Rama J. Alawneh ◽  
...  

Background: Helicobacter pylori (H.pylori) infection is the most common cause of peptic ulcer disease and it can be associated with many complications including malignancies. In clinical practice, some clinicians may use clavulanic acid (CA) in combination with amoxicillin or other beta-lactams as an addition to the standard treatment regimens. This practice may be made by habitual mistake, non-evidence based hypothetical assumptions, or by prescribing it as an alternative treatment. This review aims to expose the effect of CA against H.pylori infection and to review the possible mechanisms that may contribute to that effect. Methods: A PubMed and Google Scholar literature search was obtained on both pre-clinical and clinical studies related to CA and H.pylori infection. Results: Available clinical studies showed improvement in the eradication of H. pylori by about 10-20% when CA was added to the treatment regimens. This effect for CA could be related to several mechanisms including inhibition of H. pylori growth by binding to penicillin-binding proteins (PBPs), the transformation of H. pylori from the active filamentous form into coccoidal form, induction of the release of dopamine, modulation of immunological response towards H. pylori infection and its relationship with other microbiota. Randomized-controlled studies on patients with resistance H. pylori are needed. Moreover, In_vitro studies to evaluate the mechanisms by which CA may influence H. pylori are warranted. Conclusion: The presented literature suggests potential avenues for the use of CA in the management of peptic ulcer disease and H.pylori infection.


2009 ◽  
Vol 46 (3) ◽  
pp. 204-208
Author(s):  
Carlos Alexandre Gonçalves Batista ◽  
Fernando Marcuz Silva ◽  
Ricardo Correa Barbuti ◽  
Jaime Natan Eisig ◽  
Rejane Mattar ◽  
...  

CONTEXT: Whether Helicobacter pylori infection is a protective or predisposing factor for the development of gastroesophageal reflux disease remains controversial. The most virulent strains, such as those expressing the cytotoxin-associated gene A (CagA), and the site of gastric colonization have been correlated with the prevention or development of esophagitis. AIM: To determine the incidence of erosive esophagitis following eradication of H. pylori in patients with peptic ulcer disease and to evaluate the association of erosive esophagitis with virulent strains of H. pylori and the site of gastric colonization. METHODS: Triple therapy with lansoprazole, amoxicillin and clarithromycin was administered to 159 patients with peptic ulcer disease. Endoscopy, histopathology, urease and carbon-14 urea breath tests were performed prior to treatment, at 3 months and 1 year following treatment. Genotyping of H. pylori strains using polymerase chain reaction was performed separately on samples from the corpus and antrum. RESULTS: One year after treatment, 148 successfully treated patients were reevaluated. Twenty-eight patients (19%) had erosive esophagitis, classified as Los Angeles grade A in 24 and B in 4. The samples taken from the corpus were CagA-positive in 18 patients (64%), while the samples taken from the antrum were CagA-positive in 21 patients (75%). CONCLUSIONS: The incidence of erosive esophagitis in peptic ulcer patients who had their H. pylori eradicated was 19%. No correlation was found between the gastric site colonized by H. pylori or strains expressing CagA and the prevention or development of erosive esophagitis in patients with peptic ulcer disease, 1 year after infection eradication.


Sign in / Sign up

Export Citation Format

Share Document