Correlating Upper GI Symptoms and Endoscopic Findings with H Pylori Positivity

Title: Correlating Upper GI Symptoms and Endoscopic Findings with H Pylori Positivity – A Rural Tertiary Care Perspective

Authors: Shuba Srinivasan, Sneha Thomas, Ramkumar Kurpad R, Prakash H, Muddegowda, Jyothi B Lingegowda, Chinnappa Rajan

DOI: http://dx.doi.org/10.18535/jmscr/v4i10.24

Abstract

References

Corresponding Author

Abstract

Introduction: H pylori infection is associated with wide spectrum of neoplastic and non-neoplastic lesions and commonly presents as dyspepsia. Upper gastrointestinal endoscopy not only helps to differentiate between organic and functional dyspepsia, but also helps in the diagnosis of H pylori infection. In this study we aim to assess the prevalence of helicobacter pylori associated gastrointestinal diseases using rapid urease test (RUT) in patients undergoing endoscopy with upper GI symptoms in rural Kerala.

Materials and Methods: This observational cross sectional descriptive study was done in the Department of Gastroenterology at DM Wayanad institute of medical sciences, which is a tertiary care setup in rural Kerala. 510 patients, who underwent gastrointestinal endoscopy for various upper GI symptoms were included in the study. After applying exclusion criteria, 479 patients with demographic details, upper GI symptoms list, endoscopic findings and H pylori results formed the crux of the study.

Results: Among 479 patients evaluated, males (58%) were predominant.248 (51.7%) of the 479 patients were H pylori positive. Dyspepsia (66.5%) was the commonest symptom amongst the H pylori positive patients. Gastritis was the commonest endoscopic finding followed by esophagitis and duodenal ulcer both in the general study group and in the H pylori positive group. Amongst 8 patients with carcinoma of stomach, 7 patients were positive for H pylori infection and this association was statistically significant.

Conclusion: Dyspepsia as a symptom has great social and economic impact and is the commonest symptom presenting to the physician. Being a developing country with limited resources and its ever increasing elderly population and high prevalence of H pylori and dyspeptic symptoms, larger study to frame appropriate guidelines for endoscopy and empirical treatment of dyspepsia is desired.

Keywords: H pylori, upper gastrointestinal endoscopy, dyspepsia, rural Kerala.

References

1. Shaukat A, Want A, Acosta RD, Bruining DH, Chandrasekhara V, Chathadi KV, et al. The role of endoscopy in dyspepsia. ASGE standards of practice committee. Gastrointest Endosc. 2015;82(2):227-32.

2. Talley NJ, Vakil N. Guidelines for the management of dyspepsia. Am J Gastroenterol. 2005;100(10):2324-37.

3. Bytzer P, Talley NJ. Dyspepsia. Ann Intern Med. 2001;134:815-22.

4. Chen SL, Gwee KA, Lee JS, Miwa H, Suzuki H, Guo P, et al. Systematic review with meta-analysis: prompt endoscopy as the initial management strategy for uninvestigated dyspepsia in Asia. Aliment Pharamacol Ther. 2015;41(3):239-52.

5. Shrestha R, Koirala K, Raj KC, Batajoo KH. Helicobacter pylori infection among patients with upper gastrointestinal symptoms: prevalence and relation to endoscopy diagnosis and histopathology. J Family Med Prim Care. 2014;3(2):154-8.

6. Oling M, Odongo J, Kituuka O, Galukande M. Prevalence of Helicobacter pylori in dyspeptic patients at a tertiary hospital in low resource setting. BMC Res Notes. 2015;23(8):256.

7. Jemilohun AC, Fadare JO. Dyspepsia management in a resource poor setting. Ann Ib Postgrad Med. 2013;11(1):2-6.

8. El-Serag HB, Talley NJ. Health-related quality of life in functional dyspepsia. Aliment Pharmacol Ther. 2003;18(4):387-93.

9. Agreus L, Borgquist L. The cost of gastro-oesophageal reflux disease, dyspepsia and peptic ulcer disease in Sweden. Pharmacoeconomics 2002;20(5):347-55.

10. Vogiatzi P, Cassone M, Luzzi I, Lucchetti C, Otvos L Jr, Giordano A. J Cell Biochem. 2007;102(2):264-73.

11. Bruce MG, Maaroos HI. Epidemiology of Helicobacter pylori infection. Helicobacter 2008;13(Suppl 1):1-6.

12. Ayana SM, Swai B, Maro VP, Kibiki GS. Upper gastrointestinal endoscopic findings and prevalence of Helicobacter pylori infection among adult patients with dyspepsia in northern Tanzania. Tanzan J Health Res. 2014;16(1):16-22.

13. Malfartheiner P, Megraud F, O’Morain CA, Atherton J, Axon ATR, Bazzoli F, et al. Management of Helicobacter pylori infection – the Maastricht IV/ Florence Consenus Report. Gut. 2012;61:646-64.

14. Yuvaraj NA, Vengadakrishnan K. Outcome of Index upper gastrointestinal endoscopy in patients presenting with dyspepsia in a tertiary care hospital. International journal of scientific study 2015;2(11):106-11.

15. Khan N, Shabbir G, Zarif M, Khattak MI. Upper gastrointestinal endoscopic assessment of patients presenting with dyspepsia. JPMI. 2007;21(3):212-6.

16. Talley NJ, Ford AC. Functional dyspepsia. N Engl J Med. 2015;373(19):1853-63.

17. Lee H, Jung HK, Huh KC. Current status of functional dyspepsia in Korea. Korean J Intern Med. 2014;29(2):156-65.

18. Ndraha S, Simadibrata M. Upper gastrointestinal endoscopic and histopathological findings in patients with dyspepsia. The Indonesian Journal of Gastroenterology, Hepatology and digestive Endoscopy 2013;13(1):23-8.

19. Adlekha S, Chadha T, Krishnan P, Sumangala B. Prevalence of helicobacter pylori infection among patients undergoing upper gastrointestinal endoscopy in medical college hospital in Kerala, India. Ann Med Health Sci Res. 2013;3(4):559-63.

20. Jemilohun AC, Otegbayo JA, Ola SO, Oluwasola OA, Akere A. Prevalence of helicobacter pylori among Nigerian patients with dyspepsia in Ibadan. Pan African Medical Journal 2011;6:18.

21. Mohammed MO. Correlation of endoscopic findings with various helicobacter pylori tests among dyspeptic patients. International journal of clinical medicine 2014;5:1180-8.

22. Colmers-Gray IN, Vandermeer B, Greidanus RI, Kolber MR. Helicobacter pylori status among patients undergoing gastroscopy in rural northern Alberta. Can Fam Physician. 2016;62(9):e547-e554.

23. Faintuch JJ, Silva FM, Navarro-Rodriguez T, Barbuti RC, Hashimoto CL, Rossini AR, et al. Endoscopic findings in uninvestigated dyspepsia. BMC Gastroenterol. 2014;14:19.

24. Axon A, Forman D. Helicobacter gastroduodenitis: a serious infectious disease. BMJ. 1997;314(7092):1430-1.

25. Thirumurthi S, Graham DY. Helicobacter pylori infection in India from a western perspective. Indian J Med Res. 2012;136(4):549-62.

26. Eusebi LH, Zagari RM, Bazzoli F. Epidemiology of Helicobacter pylori infection. Helicobacter 2014;19(Suppl 1):1-5.

27. Mhaskar RS, Ricardo I, Azliyati A, Laxminarayan R, Amol B, Santhosh W, et al. Assessment of risk factors of Helicobacter pylori infection and peptic ulcer disease. J Glob Infect Dis. 2013;5(2):60-7.

28. Kodama M, Murakami K, Okimoto T, Fukuda Y, Shimoyama T, Okuda M, et al. Influence of proton pump inhibitor treatment on Helicobacter pylori stool antigen test. World J Gastroenterol. 2012;18(1):44-8.

29. Siavoshi F, Saniee P, Khalili-Samani S, Hosseini F, Malakutikhah F, Mamivand M, et al. Evaluation of methods for H. pylori detection in PPI consumption using culture, rapid urease test and smear examination. Ann Transl Med. 2015;3(1):11.

30. Petrovic M, Artiko V, Novosel S, Ille T, Sobic-Saranovic D, Pavlovic S, et al. Relationship between Helicobacter pylori infection estimated by 14C-urea breath test and gender, blood groups and Rhesus factor. Hell J Nucl Med. 2011;14(1):21-4.

31. Uemura N, Okamoto S, Yamamoto S, Matsumura N, Yamaguchi S, Yamakido M, et al. Helicobacter pylori infection and the development of gastric cancer. N Engl J Med. 2001;345(11):784-9.

32. Wroblewski LE, Peek RM Jr, Wilson KT. Helicobacter pylori and gastric cancer: Factors that modulate disease risk. Clin Microbiol Rev. 2010;23(4):713-39.

33. Chey WD, Wong BC. American college of gastroenterology guideline on the management of Helicobacter pylori infection. Am J Gastroenterol. 2007;102(8):1808-25.

Abstract

References

Corresponding Author

Call For Paper Volume 12 Issue 12 December 2024

JMSCR Menu

Impact Factor SJIF 2024: 7.892

Crossref - DOI

Editorial Policy

Frequency of Publication

Submission of Articles

Search