ABSTRACT
Background: The prevalence of Helicobacter pylori (H. pylori) infection and its virulent strain (cytotoxin-associated gene A: CagA) has not been evaluated in patients with gastroesophageal reflux disease (GERD) subgroups (erosive and non-erosive) in Iran. AIMS: This study was conducted to evaluate H. pylori infection and anti-CagA status in GERD. Setting and Design: One hundred fifty-four patients (71 male and 83 female; mean age, 42.6± 15.5 years) were evaluated for symptoms - heartburn and acid regurgitation - compatible with GERD. Materials and Methods: The esophagus was diagnosed endoscopically whether it was with erosion (erosive reflux disease, ERD) or without erosion (non-erosive reflux disease, NERD). Rates of anti-H. pylori and anti-CagA-IgG (immunoglobulin G) antibodies were determined for each subject by ELISA. H. pylori was considered by ELISA if the rapid urease test proved positive. Statistical Analysis: anti-H. pylori and anti-CagA statuses were compared in ERD and NERD patients with and without related IgG antibodies. Mean values and P values were calculated using SPSS (version 12). Results: The overall prevalence of H. pylori infection was 75.3% (116/154). Anti-CagA antibody was found in 60.3% (70/116) of infected patients. The prevalence of H. pylori infection in patients with NERD and ERD was 81.2% (56/69) and 70.6% (60/85), respectively (OR= 0.56; 95% CI [confidence interval]= 0.26-1.20; P= .14). The prevalence of anti-CagA antibody in infected NERD and ERD patients was 58.9% (33/56) and 61.7% (37/60), respectively (OR= 1.16; 95% CI= 0.49-1.70; P= 0.83). Conclusion: The results showed that more than 70% of the patients, either NERD or ERD, acquire H. pylori infection. Anti-CagA antibody is also common in patients with reflux disorders in our community.
Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Antibodies, Bacterial/blood , Antigens, Bacterial/genetics , Antigens, Bacterial/immunology , Bacterial Proteins/genetics , Bacterial Proteins/immunology , Bacterial Toxins/genetics , Bacterial Toxins/immunology , Body Mass Index , Confidence Intervals , Cytotoxins/genetics , Cytotoxins/immunology , Female , Gastroesophageal Reflux/diagnosis , Gastroesophageal Reflux/epidemiology , Gastroesophageal Reflux/microbiology , Helicobacter Infections/diagnosis , Helicobacter Infections/epidemiology , Helicobacter Infections/microbiology , Helicobacter pylori/genetics , Helicobacter pylori/immunology , Helicobacter pylori/isolation & purification , Humans , Immunoglobulin G/blood , Iran/epidemiology , Male , Middle Aged , Odds Ratio , Prevalence , Surveys and Questionnaires , Young AdultABSTRACT
PURPOSE: To assess the pattern of antimicrobial susceptibility profile of Helicobacter pylori isolates from patients with gastritis, duodenal ulcer (DU) and gastroesophageal reflux disease (GERD) residing in Shiraz, Iran. METHODS: One hundred and six H. pylori isolates from patients with gastritis, DU and GERD undergoing endoscopy at our university hospitals and clinics were analysed for their antimicrobial susceptibility to metronidazole, clarithromycin, amoxicillin, co-amoxiclav, tetracycline, ciprofloxacin and furazolidone. The minimum inhibitory concentrations were determined by agar dilution method. RESULTS: Overall H. pylori resistance rate was 72.6% to metronidazole, 9.4% to clarithromycin and furazolidone, 20.8% to amoxicillin and 4.7% to tetracycline and ciprofloxacin. No resistance to co-amoxiclav was detected among H. pylori isolates. No significant differences between antimicrobial resistance and clinical outcome were detected. CONCLUSIONS: With regard to the increasing resistance of H. pylori isolates to various antibiotics, susceptibility testing of H. pylori isolates prior to the treatment of infection must be performed to achieve better eradication and to reduce the risk of selection of H. pylori resistant strains.
Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Anti-Bacterial Agents/pharmacology , Child , Duodenal Ulcer/microbiology , Endoscopy, Digestive System , Female , Gastritis/microbiology , Gastroesophageal Reflux/microbiology , Helicobacter Infections/microbiology , Helicobacter pylori/drug effects , Humans , Iran , Male , Microbial Sensitivity Tests , Middle Aged , Treatment OutcomeABSTRACT
OBJECTIVE: To assess whether corpus gastritis due to Helicobacter pylori protects against erosive esophagitis in an area with high prevalence of H. pylori infection. METHODS: Biopsies obtained from gastric corpus and antrum in 151 patients with symptoms of gastroesophageal reflux disease were studied for presence of H. pylori and endoscopic evidence of gastritis. Presence and grade of esophagitis at endoscopy was recorded. RESULTS: Fifty-four (36%) patients had endoscopic esophagitis. Patients with severe esophagitis (>or= grade II) less often had active gastritis (15/45 vs. 55/98; p=0.02) and had a lower density of H. pylori (p=0.0003) than those without esophagitis. CONCLUSION: Active corpus gastritis due to H. pylori infection may protect against erosive esophagitis in patients with gastroesophageal reflux disease in the Middle East.
Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Esophagitis, Peptic/prevention & control , Female , Gastritis/microbiology , Gastroesophageal Reflux/microbiology , Helicobacter Infections/complications , Helicobacter pylori , Humans , Male , Middle Aged , Saudi ArabiaABSTRACT
Avanços significativos ocorridos desde o Primeiro Consenso Brasileiro sobre H. pylori realizado em 1995, em Belo Horizonte, MG, justificam este segundo consenso. O evento foi organizado pela Federação Brasileira de Gastroenterologia e pelo Núcleo Brasileiro para Estudo do Helicobacter, sendo realizado em São Paulo nos dias 19 e 20 de junho de 2004. Contou com a participação das principais autoridades nacionais na área, a partir de lista elaborada pelas duas sociedades organizadoras do evento. Assim, participaram 36 delegados provenientes de 15 estados brasileiros, incluindo gastroenterologistas, patologistas, pediatras e microbiologistas. Os participantes foram alocados em um dos cinco sub-temas a serem contemplados no encontro, a saber: Helicobacter pylori e dispepsia funcional; Helicobacter pylori e AINEs; Helicobacter pylori e doença do refluxo gastroesofágico; tratamento Helicobacter pylori e retratamento Helicobacter pylori. Foi adotado como consensual as decisões que atingissem 70 por cento ou mais de concordância entre os participantes. Os resultados foram apresentados em outubro de 2004 durante sessão especial da VI Semana Brasileira do Aparelho Digestivo, realizada em Recife, PE, e esta publicação apresenta o sumário das principais recomendações e conclusões do evento.
Subject(s)
Humans , Anti-Bacterial Agents/therapeutic use , Helicobacter pylori , Helicobacter Infections/drug therapy , Anti-Inflammatory Agents, Non-Steroidal/adverse effects , Brazil , Drug Administration Schedule , Dyspepsia/drug therapy , Dyspepsia/microbiology , Gastroesophageal Reflux/drug therapy , Gastroesophageal Reflux/microbiology , Helicobacter Infections/diagnosisABSTRACT
Objetivos: determinar la asociación entre Helicobacter pylori y los síntomas de reflujo gastroesofágico. Diseño: estudio de casos y controles anidado en un estudio de prevalencia analítica. Lugar: hospital Pablo VI Bosa. Pacientes: durante dos años se evaluaron en el servicio de gastroenterología 1.400 pacientes consecutivos, remitidos por síntomas dispépticos, procedentes de consulta externa para realizar endoscopio de vías digestivas altas. Antes del procedimiento endoscópico, la información de cada paciente fue consignada en un formulario específico previamente diseñado. Hacían parte de la misma los datos de identidad, sexo, edad y síntomas clásicos de reflujo gastroesofágico (RGE), pirosis y regurgitación, tanto en frecuencia por semana, como duración. Se consideraron casos los individuos sin Helicobacter pylori a la histología gástrica (116 individuos). Aleatoriamente se seleccionaron 232 controles con presencia histológica de Helicobacter pylori. Métodos: a cada uno de los 348 pacientes incluidos en el estudio se les practicó una endoscopia digestiva alta. Biopsias para histopatología, coloración de hematoxilina y eosina y Giemsa: esófago distal (2), cardias (3), cuerpo gástrico m (4), antro gástrico (4), una de estas pruebas se utilizó para test rápido de ureasa. Análisis estadístico: se realizó análisis univariado y bivariado. Como medida de asociación se calculó la razón de disparidad (OR). Para establecer significancia estadística se utilizó la prueba de Chi2, valor alfa del 5 por ciento. Resultados: no hubo diferencias estadísticamente significativas entre los casos (Gl) y los controles (G2) para edad (p = 0.363) y sexo (p == 0.7). Se encontró una tendencia lineal inversa entre severidad de inflamación de la mucosa gástrica y la presencia de síntomas de RGE (Chi2 de tendencia = I 6.2, p = 0.00006) y evidencia histológica de esofagitis (Chi de tendencia 4.19, p = 0.04). La presencia de inflamación gástrica severa tuvo relación inversa con los síntomas de RGE (Chi2 = 5.9, p = 0.0/5, OR = 0.26, IC95 por ciento: 0.07- 0.92) J con esofagitis histológica (Chi 2 = 4.9, p = 0.025, OR = 0.30, IC 95 por ciento: 0.01- 1)...
Subject(s)
Helicobacter pylori , Gastroesophageal Reflux/diagnosis , Gastroesophageal Reflux/microbiology , Gastroesophageal Reflux/prevention & controlABSTRACT
El test respiratorio utilizando urea marcada con C es un método no invasivo empleado desde 1988 para detectar la presencia de Helicobacter pylori en pacientes portadores de enfermedad ácido péptica. Este método ha demostrado una sensibilidad del 90,2 por ciento y especificidad de 83,8 por ciento . En el Centro de Medicina Nuclear de Guanabara fueron realizados 1.200 test respiratorios, de los cuales el 67 por ciento se reportaron positivos, realizándose nuevos controles después del tratamiento médico, con resultados negativos
Subject(s)
Humans , Breath Tests , Gastritis/etiology , Helicobacter Infections/diagnosis , Helicobacter pylori/isolation & purification , Carbon Radioisotopes , Carbon Dioxide , Stomach/microbiology , Ethanolamines , Gamma Cameras , Gamma Cameras/instrumentation , Gamma Cameras/standards , Gastritis/diagnosis , Helicobacter pylori/physiology , Gastroesophageal Reflux/microbiology , Peptic Ulcer/diagnosis , Peptic Ulcer/etiology , Urease , Urease/metabolism , Urease/pharmacologyABSTRACT
Se presentan 60 pacientes con síntomas consistentes con reflujo gastroesofágico (RGE) y gastritis crónica. Los síntomas más importantes encontrados fueron: pirosis 98.3 por ciento, regurgitación 93.8 por ciento, faringitis a repetición 83.3 por ciento, laringitis frecuente 80 por ciento, disfagia 80 por ciento, disfonía 78.3 por ciento, dolor epigástrico 98.3 por ciento, dispepsia 90 por ciento. todos los pacientes (100 por ciento) presentaron una gastritis crónica antral con 51.6 por ciento de tipo crónica superficial y 48.4 por ciento crónica atrófica. solamente seis pacientes (9.6 por ciento) tenían algún tipo de metaplasia. De los pacientes con gastritis crónica antral, 18 (30 por ciento) tenían Helicobacter pylori en las biopsias de antro. Veintidós pacientes (36.6 por ciento) presentaron una esofagitis péptica demostrada histológicamente pero ninguno mostró Helicobacter. Se discute la estrecha relación encontrada entre reflujo gastroesofágico y gastritis antral y su posible fisiopatología, así como la falta de correlacción entre el reflujo y la presencia delHelicobacter en el esófago.