frequency of Helicobacter pylori infection in gastric biopsies of patients with gallbladder stones

There were few studies reporting simultaneous presence of Helicobacterpylori [H.pylori] in stomach and gallbladder stones, most of which have been conducted on bile specimens or gallbladder tissues. Presence of a chronic inflammatory disease may contribute to gallstone formation through production of inflammatory cytokines. Chronic active gastritis due to H.pylori may contribute to lithogenesis in gallbladder. In this regard, the present study aimed to investigate the frequency and association of gastric H.pylori infection and gallstones in patients who were undergoing upper endoscopy in a teaching hospital. In this case-control study patients presenting with dyspeptic symptoms who underwent upper endoscopy during 2008-2012 in Shahid Beheshti Hospital of Babol, northern Iran were enrolled, 72 patients with and 136 patients without gallstones were assigned as the case and control groups, respectively. Patients with history of gastric surgery PPI, and antibiotic consumption four weeks before endoscopy were excluded from the study. Two biopsies were obtained from gastric antrum and body of each patient in both groups and examined histologically for gastritis and the presence of H.pylori. Then, endoscopic, histological and demographic features [age, gender, BMI, smoking, NSAID] in these two groups were compared. The SPSS software [version 18] was used for analysis. P-value of 0.05 was considered as statistically significant. Fifty-two [72.2%] and 98 [72.1%] of all patients with and without gallstone were female, respectively [p=0.7]. The mean age of patients with gallstone was 51.8 +/- 14 years, while it was 51.1 +/- 15 years in patients without gallstone [p= 0.9]. H.pylori was detected in gastric mucosa of 31 [43.1%] and 45 [33.8%] cases with and without gallstone, respectively. Although H.pylori infection was higher in patients with gallstones, the difference was not statistically significant [p =0.19]. In the group with gallstones, 21 [29.2%] patients revealed severe gastritis, and in those without gallstones, 17 [12.5%] patients were found with severe gastritis. This difference was statistically significant [p=0.003, OR=2.88, CI: 1.41-5.91]. This study demonstrates that patients with severe H.pylori induced gastritis are likely to have gallstone in comparison with mild gastritis. The frequency of H.pylori infection in patients with gallstones is more than those without gallstones

[Efficacy of domperidone and pyridostigmine in the treatment of patients with functional dyspepsia: a randomized clinical trial]

The majority of dyspeptic patients do not have identifiable disease, which is also known as functional dyspepsia. The therapeutic approach to patients with functional dyspepsia is still a matter of debate; prokinetic agents are commonly used for symptom relief. This study aims to evaluate the efficacy of domperidone and pyridostigmine [an inhibitor of cholinesterase] in patients with functional dyspepsia. This was a single-blind, randomized clinical trial performed on 117 patients [December 2007 to November 2009] diagnosed with functional dyspepsia according to ROME II criteria. The effects of 4 weeks of treatment with domperidone [10 mg tid], yridostigmine [60 mg tid], and placebo were compared. We scored each patient according to VAS to rank the severity of 8 different upper GI symptoms [epigastric fullness, early satiety, gnawing, nausea, vomiting, belching, bloating, and epigastric pain] both before and at the end of treatment. Data were entered into SPSS software version 16 and analyzed. P<0.05 was considered significant. At the end of treatment, the total dyspeptic symptom score decreased from 24 to 13. According to ANOVA, there were significant differences between the 3 groups in 3 out of 8 symptom scores of bloating [p=0.039], early satiety [p=0.006], and nausea [p=0.016]. The post hoc test determined that domperidone was more effective than pyridostigmine and placebo in improvement of early satiety [p=0.038 and p=0.014, respectively]. Domperidone was more effective than pyridostigmine in the control of nausea [p=0.024]. Domperidone [p=0.023] and pyridostigmine [p=0.042] were superior in relieving bloating symptoms compared to placebo. Overall, in the control of GI symptoms domperidone was more effective than placebo [p=0.045]. domperidone and pyridostigmine are useful in improving bloating, early satiety, and nausea. However they are similar to placebo in controlling epigastric pain, fullness, belching and gnawing