HELICOBACTER AND HEPATOBILIARY DISEASES: UPDATE 2023.

•Clinical studies have shown that hepatobiliary diseases of inflammatory and neoplastic origin are associated with Helicobacter infection. •Translocation and the ascending pathway are putative mechanisms for Helicobacter spp to enter the hepatobiliary system. •H. pylori infection has a systemic effect through the activity of pro-inflammatory cytokines, TNF-α, leukotrienes, interferon-ß, interferon-γ, and acute phase proteins. •Histopathological confirmation is needed to present that H. pylori eradication prevents or improves hepatobiliary disease progression. Helicobacter Pylori (H. pylori) is one of the main infectious causes of gastroduodenal diseases, however, its role in developing different extragastric diseases has been proven. The possible involvement of H. pylori in the pathogenesis of cardiovascular, metabolic, neurodegenerative, skin, and hepatobiliary diseases is suggested. The bacterium has been found in tissue samples from the liver, biliary tract, and gallstones of animals and humans. However, the role of H. pylori infection in the pathogenesis of liver and biliary diseases has not been finally established. The histopathological confirmation of the positive effect of H. pylori eradication is needed. In addition, there are discussions on the clinical significance of other Helicobacter species. The review presents the data available for and against the involvement of H. pylori in hepatobi-liary disease development and progression.

Helicobacter pylori e as doenças hepatobiliares: atualização 2023 / Helicobacter and hepatobiliary diseases: update 2023

ABSTRACT Helicobacter Pylori (H. pylori) is one of the main infectious causes of gastroduodenal diseases, however, its role in developing different extragastric diseases has been proven. The possible involvement of H. pylori in the pathogenesis of cardiovascular, metabolic, neurodegenerative, skin, and hepatobiliary diseases is suggested. The bacterium has been found in tissue samples from the liver, biliary tract, and gallstones of animals and humans. However, the role of H. pylori infection in the pathogenesis of liver and biliary diseases has not been finally established. The histopathological confirmation of the positive effect of H. pylori eradication is needed. In addition, there are discussions on the clinical significance of other Helicobacter species. The review presents the data available for and against the involvement of H. pylori in hepatobi­liary disease development and progression.

RESUMO Helicobacter pylori (H. pylori) é uma das principais causas infecciosas de doenças gastroduodenais, no entanto, seu papel no desenvolvimento de diferentes doenças extragástricas tem sido comprovado. Sugere-se o possível envolvimento do H. pylori na patogênese de doenças cardiovasculares, metabólicas, neurodegenerativas, cutâneas e hepatobiliares. A bactéria tem sido encontrada em amostras de tecido do fígado, trato biliar e cálculos biliares de animais e humanos. No entanto, o papel da infecção por H. pylori na patogênese de doenças do fígado e das vias biliares ainda não foi estabelecido definitivamente. A confirmação histopatológica do efeito positivo da erradicação do H. pylori é necessária. Além disso, existem discussões sobre a importância clínica de outras espécies de Helicobacter. A revisão apresenta os dados disponíveis a favor e contra o envolvimento do H. pylori no desenvolvimento e progressão das doenças hepatobiliares.

The Usefulness of Water-drinking Ultrasonography Combined Test for Evaluating Patients with Functional Dyspepsia.

BACKGROUND/AIMS: The major causes of functional dyspepsia (FD) are motility dysfunction and visceral hypersensitivity. Despite the large number of diagnostic tests, there are no convenient methods for evaluation of gastric functions. Therefore, this study was conducted to assess the relationship between the degree of dyspepsia and gastric accommodation, emptying, and sensitivity. METHODS: A total of 120 FD patients that met the Rome III criteria and 30 healthy volunteers were included in this cross-sectional study. The mean cross-sectional area of the fornix was measured to investigate fundic accommodation and gastric emptying during and after water intake. During the test, abdominal symptoms were evaluated using the 4-point Likert scale. RESULTS: The water-drinking ultrasonography combined test revealed impairment of gastric accommodation in FD after 1,000 mL of water intake, delayed emptying after 5 min of water intake and statistically significant hyperesthesia after 400 mL of water intake in the FD group compared with healthy controls (p <œœ 0.05). Postprandial distress syndrome (PDS) and overlap syndrome were independently associated with gut motor disturbances instead of epigastric pain syndrome (EPS) (p <œœ 0.01). CONCLUSIONS: The results of the present study suggest that the water-drinking ultrasonography combined test could be used for diagnosis of gastric motor and sensory dysfunction, particularly in PDS and EPS-PDS patients. This test is easy, well tolerated by the patient and can be widely applied in clinical practice.