The Role of Helicobacter pylori and NSAID in Patients with Benign Gastric Ulcer / 대한내과학회지

OBJECTIVES: H. pylori infection and NSAID are very important risk factors for peptic ulcer. This study was conducted to investigate the H. pylori positivity rate and the rate of NSAID ingestion in the patients with benign gastric ulcer(BGU), to investigate which test and which site are the most adequate to reduce the false positivity rate of H. pylori, and finally to investigate the role of H. pylori and NSAID in BGU bleeding. METHODS: This study was conducted for the 180 patients with BGU, and H. pylori was diagnosed by any of CLO test, Gram stain of touch print and H&E stain in the antrum and body. In addition, age, sex, ingestion history of NSAID within 4 weeks before gastroscopy, past BGU history, smoking, alcohol and BGU bleeding were investigated. RESULTS: 1) The H. pylori infection rate of patients with BGU in Korea was 82.8%, and the rate of NSAID history was 26.1%. The patients with BGU who have only NSAID history were 8.3%, and the 91.1% of the patients had either H. pylori infection or NSAID history. 2) The most sensitive test for H. pylori infection among CLO test, Gram stain of touch print and H&E stain in the antrum or body was CLO test in the body. 3) Depending on H. pylori positivity, the rate of NSAID history in the H. pylori negative group was 48.4%, which was higher than that of H. pylori positive, 21.5%(p=0.002). In addition, the rate of past BGU history in the H. pylori positive group was 47.0%, which was higher than that of H. pylori negative, 12.9%(p<0.001). 4) Depending on the history of NSAID, the H. pylori positivity rate in NSAID positive group was 68.1%, which was lower than that of NSAID negative, 88.0%(p=0.002). The female percentage of NSAID positive was 40.4%, which was higher than that of NSAID negative, 16.5% (p<0.001). The rate of BGU bleeding in the NSAID positive was 27.7%, which was higher than that of NSAID negative, 14.3%(p=0.039). 5) The rate of NSAID history of bleeding group was 40.6%, which was higher than that of non-bleeding group, 23.0%(p=0.039). However, there was no signifi cance in the correlation of H. pylori positivity rate to the bleeding. 6) The H. pylori positivity and NSAID history showed no correlation with bleeding in the group below age sixty. While in the age over or equal to sixty the H. pylori positivity had no correlation with bleeding, but the rate of NSAID history was 72.7% for the patients with bleeding, which is in contrast with the 25.5% for the patients without bleeding(p=0.003). CONCLUSION: From these results, the H. pylori infection rate of the patients with BGU in Korea was 82.8%, and the best method for H. pylori detection was CLO test in the body. H. pylori infection had no corre lation with the bleeding, but NSAID ingestion increased bleeding tendency, particularly in the group of the age over or equal to sixty.

A Case of Focal Lymphoid Hyperplasia of the Rectum Presented with Hematochezia / 대한소화기내시경학회지

Pseudolymphoma or benign lymphoid hyperplasia is an unusual pathologic entity representing lymphoid hyperplasia, which is sometimes not easily classified as reactive or neoplasic. It occurs in a wide variety of sites, including the orbit, salivary glands, skin, thyroid, gastrointestinal tract and lung. Within the gastrointestinal tract, stomach, small intestine and large intestine, particulary rectum, can be involved, but intestine including rectum has been rarely reported in Korea to the best of our knowlege. We experienced a case of focal lymphoid hyperplasia of the rectum presented with hematochezia in a 33-year old male. It was diagnosed by histopathology with sigmoidoscopic biopsy and molecular genetic study. Rectal lesion as well as hematochezia was improved by prednisolone and mesalamine enema therapy. Hence, we report this case with a brief review of literatures.