scholarly journals Helicobacter pylori Infection in Patients with Portal Hypertensive Gastropathy Owing to Liver Cirrhosis: Prevalence and Relation with Severity of Gastropathy

2017 ◽  
Vol 08 (03) ◽  
pp. 123-128
Author(s):  
Shekhar Puri ◽  
Mukesh Jain ◽  
Kumar Shwetanshu Narayan ◽  
Sudhakar Pandey ◽  
Sandeep Nijhawan

ABSTRACT Background and Aim: Helicobacter pylori is a major human pathogen. Its role in the pathogenesis of portal hypertensive gastropathy (PHG) is debated. The aim of this study was to evaluate the prevalence of this infection in patients with portal hypertension due to liver cirrhosis and its relation with severity of gastropathy. Patients and Methods: Sixty consecutive patients with liver cirrhosis were enrolled in the study. All patients were subjected to an upper gastrointestinal endoscopy (UGIE), and rapid urease testing for H. pylori was performed. The diagnosis and severity of PHG was evaluated on UGIE. ChildαTurcotteαPugh (CTP) and model for endαstage liver disease (MELD) scores were calculated to assess the severity of liver cirrhosis. Results: H. pylori infection was reported in 33 patients with overall prevalence 55%. The presence of H. pylori was observed in 26 (67%) cirrhotic patients with PHG compared to 7 (33%) cirrhotic patients without PHG. The risk estimate showed a significant association between H. pylori and PHG in cirrhotic patients (P = 0.0133, odds ratio [OR]: 4.00, 95% confidence interval [CI]: 1.298–12.325). Out of the 26 patients with PHG and H. pylori infection, 17 had severe PHG (65.3%) and 9 had mild PHG (34.6%) whereas 4 patients had severe PHG (30.8%) and 9 had mild PHG (69.2%%) in the group of H. pyloriαnegative patients. The difference was statistically significant (P = 0.04, OR: 4.25, 95% CI: 1.0188–17.729). Of the 39 patients with PHG, 21 (53.85%) had severe PHG and 18 (46.15%) had mild PHG. No significant relation was found between H. pylori infection and severity of liver cirrhosis as regards CTP score (P = 0.76) and MELD score (P = 0.56). Conclusion: Our results showed a significant association between H. pylori infection and the occurrence and also the severity of gastropathy in patients with liver cirrhosis. Yet, the severity of liver cirrhosis itself did not correlate with H. pylori or the severity of gastropathy.

2017 ◽  
Author(s):  
Patricio Gonzalez-Hormazabal ◽  
Maher Musleh ◽  
Susana Escandar ◽  
Hector Valladares ◽  
Enrique Lanzarini ◽  
...  

AbstractBackgroundCurrent available treatments for Helicobacter pylori eradication are chosen according to local clarithromycin and metronidazole resistance prevalence. The aim of this study was to estimate, by means of molecular methods, both clarithromycin and metronidazole resistance in gastric mucosa from patients infected with H.pylori.MethodsA total of 191 DNA samples were analyzed. DNA was purified from gastric mucosa obtained from patients who underwent an upper gastrointestinal endoscopy at an university hospital from Santiago, Chile, between 2011 and 2014. H.pylori was detected by real-time PCR. A 5’exonuclease assay was developed to detect A2142G and A2143G mutations among Hpylori-positive samples. rdxA gene was sequenced in samples harboring A2142G and A2143G mutations in order to detect mutations that potentially confer dual clarithromycin and metronidazole resistance.ResultsNinety-three (93) out of 191 DNA samples obtained from gastric mucosa were H. pylori-positive (48.7%). Clarithromycin-resistance was detected in 29 samples (31.2% [95%CI 22.0%-41.6%]). The sequencing of rdxA gene revealed that two samples harbored truncating mutations in rdxA, one sample had an in-frame deletion, and 11 had amino acid changes that likely cause metronidazole resistance.ConclusionsWe estimated a prevalence of clarithomycin-resistance of 31.8% in Santiago, Chile. The proportion of dual clarithromycin and metronidazole resistance could be, at least, 15.0%. Our results require further confirmation. Nevertheless, they are significant as an initial approximation in re-evaluating the guidelines for H.pylori eradication currently used in Chile.


2020 ◽  
Vol 10 (1) ◽  
pp. 8-14
Author(s):  
Amal A. Mohamed ◽  
Shorouk Moussa ◽  
Mahmoud M. Shaheen ◽  
Sherief Abd-Elsalam ◽  
Rehab Ahmed ◽  
...  

Background & Aims: Human genetic polymorphism has been reported in the susceptibility and clinical development of infection. In this regard, this study aimed to investigate the link between Vitamin D Receptor (VDR) gene polymorphism and H. pylori infection. Materials and Methods: This cross-sectional study was conducted on 224 adult patients with upper gastrointestinal symptoms who underwent an upper gastrointestinal endoscopy between July 2017 and May 2019 in two major university hospitals. All patients were evaluated for helicobacter pylori infection. Two gastric antral biopsy specimens were taken from each patient. One of those Biopsy specimens was evaluated for histopathology examination and the other one was immersed in a saline solution ready for genomic DNA extraction. Results: There were statistically significant differences between different genotypes of VDR rs7975232 polymorphism between H. pylori infected and non-infected groups (CC was higher in H. pylori negative and AC and AA were the most common in H. pylori positive group). There were statistical differences between different genotypes of VDR rs2228570 between H. pylori infected and non-infected groups (TT was higher in H. pylori negative and CT and CC were the most common in H. pylori positive group). Regarding VDR rs 7975232 gene polymorphisms; the (A) allele was significantly higher H. pylori infected, while (C) allele was significantly higher in uninfected patients. Regarding VDR rs 2228570 gene polymorphisms; the (C) allele was significantly higher H. pylori infected, while (T) allele was significantly higher in uninfected patients. Conclusion: There is a possible association between the FokI and Apal VDR polymorphism and H. pylori infection.


2006 ◽  
Vol 63 (3) ◽  
pp. 313-315 ◽  
Author(s):  
Ratko Tomasevic ◽  
Gradimir Golubovic ◽  
Miroslav Kiurski ◽  
Dragana Stankovic ◽  
Radoje Doder ◽  
...  

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.


Author(s):  
Mariana E. Maioli ◽  
Raquel F. N. Frange ◽  
Cintia M. C. Grion ◽  
Vinicius D. A. Delfino

Abstract Introduction: Treatment for Helicobacter pylori (H. pylori) infection is recommended in transplant candidates due to the association between this infection and gastrointestinal disorders, which could significantly increase morbidity after renal transplantation with the use of immunosuppression. The objective of this study was to analyze the rate of eradication of H. pylori after antimicrobial treatment in chronic kidney disease patients who are candidates for kidney transplantation. Methods: A multicenter prospective cohort study was conducted. All adult chronic kidney disease patients seen at our institution were included. In the pre-transplantation evaluation, 83 patients underwent an upper gastrointestinal endoscopy with 2 diagnostic methods to detect H. pylori: histology and the rapid urease test. In total, 33 patients with H. pylori infection received treatment with 20 mg omeprazole, 500 mg amoxicillin, and 500 mg clarithromycin once daily for 14 days. Another upper gastrointestinal endoscopy was performed 8 to 12 weeks after the end of treatment to check for healing. Results: The study showed a prevalence of H. pylori in 51 (61.4%) patients. Histology was positive in 50 (98%) patients and the rapid urease test was positive in 31 (60.8%). The infection eradication rate was 48.5% (16 patients). Conclusions: There was a high prevalence rate of H. pylori and a low eradication rate after the long-term antimicrobial triple scheme used. The association of the rapid urease test with gastric mucosa histology did not increase the detection rate of H. pylori.


2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
F. AL Kirdy ◽  
M. Rajab ◽  
N. El-Rifai

Background. Helicobacter pylori (H. pylori) is a common and universally distributed bacterial infection. However, in children, active gastritis and ulcer are rarely seen. Objectives. The aims of this study were to establish the prevalence of H. pylori infection and to compare the clinical, endoscopic, and histopathological findings between infected and noninfected pediatric patients at Makassed General Hospital. Methods. Patients aged between 1 month and 17 years who underwent upper gastrointestinal endoscopy from January 2011 to January 2017 were included. The diagnosis of H. pylori was confirmed by a CLO test and/or its presence on biopsy specimens. Demographic data, clinical characteristics, endoscopic and histopathological findings, and gastritis score were recorded retrospectively. Results. During the study period, 651 children underwent upper gastrointestinal endoscopy. The main indication was abdominal pain (61%). The prevalence of H. pylori infection was 16.5%. The infection was most commonly seen among children aged between 6 and 10 years (43%). A large number of family members were associated with increased risk of infection (4.8±1.5 versus 5.2±1.8; p<0.05). Epigastric pain was more associated with H. pylori (61.3% versus 14.6% in noninfected patients; p<0.05). Nodular gastritis was commonly seen in infected patients (41.5% vs. 7.9%; p<0.05). Mild and moderate gastritis was seen more in infected versus noninfected patients (mild: 53.8% vs. 14%; moderate: 27.4% vs. 2.4%, respectively). Conclusion. Although epigastric pain was associated with H. pylori, other diagnoses should be considered since the infection are rarely symptomatic in children. Antral nodularity was associated with H. pylori infection; however, its absence does not preclude the diagnosis.


2020 ◽  
Vol 3 (1) ◽  
Author(s):  
Shatdal Chaudhary ◽  
Niraj Kumar Jaiswal ◽  
Aakash Shahi ◽  
Pradip Chhetri

Introduction: Liver cirrhosis is a common problem faced by physicians worldwide and is also responsible for 11th most common cause of death globally. Data regarding prevalence of esophageal varices and other upper gastrointestinal changes in patients with liver cirrhosis is scare in Nepal. So this study was carried out to find clinical profile and upper gastrointestinal endoscopic findings of patients presenting with liver cirrhosis with portal hypertension. Methods: This was a cross-sectional observational hospital based study conducted in the department of internal medicine and endoscopy unit of the Universal College of Medical Sciences, Bhairahawa, Nepal. The study was done from 21 February 2019 to 20 November 2019 in the patients presented with liver cirrhosis with portal hypertension. Sample size of 80±10 was calculated based on the statistics of previous data. The upper gastrointestinal endoscopy was done in all the patients. The data was collected using the predesigned pro-forma. Results: Total 89 patients with liver cirrhosis were enrolled with mean age of 51.84±12.26 years and male: female ratio of 3.68:1. As per Child Pugh classification (CTP) 45 patients (51%) were in Class C, 33 patients (37%) were in Class B and 11 patients (12%) were in Class A. Esophageal varices were present in 51 (57.3%) patients. According to Westaby classification grade I esophageal varices were seen in 17 (19.1%), grade II esophageal varices were seen in 26 (29.2%), grade III esophageal varices were seen in 8 (8.9%) patients. Portal hypertensive gastropathy (PHG) was seen in 64 (71%) patients. The association between esophageal varices and PHG grade was found statistically significant (P= <0.001). Conclusions: Liver cirrhosis was more commonly seen in middle age males. Esophageal varices and portal hypertensive gastropathy were common endoscopic findings present in patients with liver cirrhosis. There was statistically significant association between esophageal varices and PHG.


2017 ◽  
Vol 11 ◽  
Author(s):  
Fahad A.S. Al-Eidan ◽  
Mohamed Alnaser ◽  
Sameera M. Aljohani ◽  
Mishal Al Johani ◽  
Ahmed El Hafi ◽  
...  

There is growing concern about <em>Helicobacter pylori</em> (<em>H. pylori</em>) resistance strains being the main agent contributing to eradication failure. In this study we evaluated the prevalence and antimicrobial susceptibility trends of <em>H. pylori</em> over a period of time. Over a period of seven years a total of 384 biopsy specimens were sent to the microbiology department and evaluated for culturing <em>H. pylori</em> and assess its susceptibility. Biopsy specimens that cultured and where bacterial susceptibility was determined were regarded as <em>H. pylori</em> positive, and specimens that failed to culture were considered <em>H. pylori</em> negative. A total of 221 patients with <em>H. pylori</em> positive were assessed and antimicrobial susceptibility was determined. The overall prevalence of <em>H. pylori</em> infections among Saudis undergoing upper gastrointestinal endoscopy, with indicated specimens, was 57.6%. Antimicrobial susceptibility was evaluated; overall clarithromycin resistance was found to be 4.5% and metronidazole resistance 52.5%. The number of clarithromycin resistant strains has increased significantly from 2.5% in 2008 to 10% in 2014 (PH. pylori infection is very common among Saudi patients with peptic ulcer disease. Resistance of <em>H. pylori</em> against clarithromycin and metronidazole has increased significantly over the seven-year period. This suggests a need to monitor the annual antimicrobial susceptibility pattern.


2020 ◽  
Vol 7 (9) ◽  
pp. 3009
Author(s):  
Pranav Ganesh ◽  
Ramya Ramakrishnan ◽  
Sandhya Sundaram

Background: Helicobacter pylori infection is widely prevalent in the world especially in the developing countries. The common clinical presentation of this disease includes peptic and duodenal ulcer. A major post-infection complication of this disease is gastric carcinoma. The scope of this study was to determine the prevalence of active H. pylori infection in the local population by retrospective review of patient records, which can give a better picture of the current situation and estimate the at-risk population of gastric carcinoma. Objective of the study was to determine the prevalence of H. pylori infection in biopsy specimens obtained from upper gastrointestinal endoscopy performed in dyspeptic patients in a tertiary-care hospital.Methods: The study was performed as a retrospective review of biopsy reports of 262 dyspeptic patients with previously unknown H. pylori status who underwent upper gastrointestinal endoscopy during the months of January 2018 to May 2018. Biopsy obtained from stomach was evaluated for the presence of H. pylori infection by Rapid Urease Test (RUT) or histopathological examination.Results: The prevalence of H. pylori infection in dyspeptic patients obtained from the above study was 44.7% and was found to be more common in males compared to females.Conclusions: H. pylori is a risk factor for gastric carcinoma. Determining the prevalence with early identification of active infections results in better treatment and post infection monitoring for malignancy.


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