Association between pattern of gastritis and gastroesophageal reflux disease in patients with helicobacter pylori infection

Background: Reflux disease is a common gastrointestinal problem. The association between reflux disease and gastritis pattern is controversial

Aim: To determine the association between reflux disease and gastritis pattern in patients with Helicobacter pylori [H. pylori] infection

Methods: 470 patients with dyspepsia and reflux disease were enrolled in this study. The inclusion criteria were willing to participate in the study, age over 40 years, and having the criteria of ROME III for at least 3 months. Patients with history of H. pylori eradication therapy during the 3 months before the study, a history of gastric surgery, and gastric cancer were excluded. All of the participants underwent upper endoscopy and two biopsy samples were taken from antrum, body, and fundal areas

Results: H. pylori infection rate was 367 [78.1%] with mean age of 59.8 +/- 11.4 years. Of them 131 patients [35.7%] were male. Reflux disease was detected in 273 [74.4%] patients. 216 [58.9%] and 102 [27.8%] patients had non-erosive reflux disease [NERD] and gastroesophageal reflux disease [GERD], respectively. Corpus predominant and antral predominant gastritis were seen in 72 [19.6%] and 129 [35.2%] patients, respectively. Antral gastritis was significantly associated with GERD [p<0.01]. In regression analysis, antral predominant gastritis had a significant association with GERD [OR=1.92; 95%CI: 1.22-3.12]. The same result was observed in mild to moderate antral and greater curvature gastritis [OR= 1.26; 95%CI: 0.25-6.40 and OR= 3.0; 95%CI: 0.63-14.17, respectively]

Conclusion: According to these finding, we could suggest that the pattern of gastritis could be associated with reflux disease and GERD

Effects of silymarin on reducing liver aminotransferases in patients with nonalcoholic fatty liver diseases

The hepatoprotective effects of silymarin have been confirmed by various researchers worldwide; however few studies are available about the therapeutic impact of silymarin on the level of aminotransferases in patients with nonalcoholic steatohepatitis [NASH]. Our purpose is to determine whether silymarin improves the serum level of aminotransferases in patients with NASH. This was a double blind, randomized, placebo-controlled trial performed on 100 patients with NASH. Subjects were randomized to receive silymarin [140 mg/q12h] for three months or placebo, given in the same manner. A blood sample was drawn at baseline [before treatment] and after completion of the treatment schedule to assess serum aminotransferase levels. We measured body mass index [BMI] before and after administration of the treatments for both groups of patients. There were insignificant changes in BMI for both groups. The mean serum alanine aminotransferase [ALT] level in the case group significantly changed from 84.06 to 68.54 IU/mL following treatment with silymarin [p<0.001], however this change was not significant in the control group. The mean serum aspartate aminotransferase [AST] level in the case group significantly decreased from 71.94 to 54.70 IU/mL after treatment with silymarin. This change in the placebo group was not significant [from 62.94 to 61.56 IU/mL]. Administration of silymarin can effectively reduce liver aminotransferases without any changes in BMI in patients with NASH disease

Eradication rate of Helicobacter pylori using a two-week quadruple therapy: a report from southern Iran

The use of quadruple therapy for Helicobacter pylori [H. pylori] eradication is a highly efficacious, gold standard regimen. However, according to a number of studies, this regimen has numerous compliance problems and adverse effects. In the current study we have evaluated the H. pylori eradication rate following a quadruple therapy that included omeprazole, bismuth subcitrate, amoxicillin, and metronidazole in Hormozgan, the most southern province in Iran. Hormozgan Province has high rates of H. pylori infection and its related disorders. A total of 100 patients diagnosed with dyspepsia and H. pylori infection as documented by the [13]C-urea breath test [UBT] or rapid urease test [RUT] were treated with the following quadruple regimen: bismuth subcitrate [120 mg, 2 tablets/q12h], amoxicillin [500 mg/q8h], metronidazole [250 mg/q8h] and omeprazole [20 mg/q12h] for a two-week period. Our primary efficacy outcome was H. pylori eradication as established by a negative UBT at least four weeks after the end of treatment. Eradication rates were 79%.and 82.3%, respectively, based on the intention-to-treat and per-protocol analyses. Quadruple therapy had a similar effect in women [81%] and men [83.3%] for the eradication of H. pylori, which was not statistically significant. H. pylori eradication rates according to age groups were: 16-20 years [100%], 21-40 years [81%], and 41-60 years [77.8%; p=0.001]. There was no significant difference in H. pylori eradication rate between genders in those less than 20 years of age and the middle age group. However in the older group the eradication rate was significantly higher in women [100%] compared to men [66.6%]. A two-week quadruple therapy that includes omeprazole, bismuth subcitrate, amoxicillin and metronidazole is a highly effective treatment for H. pylori infection. This treatment has an acceptable eradication rate in Southern Iran. The eradication rate appears to be lower in older men compared with younger men or in women