Association of Helicobacter pylori infection with dyspeptic symptoms in patients undergoing gastroduodenoscopy
Article Abstract:
Dyspepsia, chronic upper abdominal pain or nausea, is a common complaint, but it is not well understood. Non-ulcer dyspepsia is twice as common as ulcers, and half the patients with this condition may have a type of chronic gastritis (stomach inflammation). However, chronic antral gastritis is also common in people without symptoms. The great majority of patients with gastric (stomach) or duodenal (upper small intestine) ulcers are infected with the bacteria Helicobacter pylori (H. pylori), but the possible cause and effect relationship between infection and ulcer is still unclear and disputed. The association of H. pylori infection with dyspeptic symptoms was evaluated in 46 dyspeptic patients (22 female, 24 male) and in 24 patients (13 female, 11 male) who were being examined for disorders of the pancreas or bile duct. H. pylori was found in digestive tract tissues of 67 percent of dyspeptic patients, but only 25 percent of the other patients. All patients who had findings associated with ulcer or inflammation of the stomach and duodenum had H. pylori infection, while 63 percent of patients with inflammation limited to the stomach were infected. Overall, H. pylori was found in 60 percent of non-ulcer dyspeptic patients, and in 4 of 9 patients with normal endoscopic findings. All patients without dyspepsia had normal endoscopic findings of the stomach and duodenum. H. pylori infection was not consistently associated with any digestive symptoms. Tests that detected blood levels of antibodies to H. pylori were more effective than those which analyzed stomach biopsy specimens. This suggests H. pylori infection may be more easily and effectively diagnosed through less invasive blood tests. The authors conclude that the association between H. pylori and active gastric inflammation provides additional evidence of the pathogenic effect of this organism. Further study of gastric disease after treatment of H. pylori infection may help to clarify this process. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Medicine
Subject: Health care industry
ISSN: 0002-9343
Year: 1990
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Helicobacter pylori-negative duodenal ulcer
Article Abstract:
A duodenal ulcer is a lesion of the mucous membrane lining the duodenum, or first part of the small intestine. Duodenal ulcers usually produce pus and may bleed. Factors that increase the risk of developing duodenal ulcers include gender, smoking, alcohol use, and use of aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs). More than 90 percent of duodenal ulcers may be caused by the bacteria Helicobacter pylori, also known as Campylobacter pylori. The risk factors of duodenal ulcer in patients with or without H. pylori infection were assessed. Patients without H. pylori infection who developed duodenal ulcers tended to use aspirin and have a history of ulcer. The inflammation of the antrum, a portion of the stomach, was more severe in H. pylori-infected patients, compared with noninfected patients with duodenal ulcer. H. pylori infection was more frequent in blacks than whites. Duodenal ulcer was most often associated with bleeding in noninfected patients, and with pain in H. pylori-infected patients. These findings suggest that the mechanisms underlying the development of duodenal ulcer differ between patients infected with H. pylori and noninfected patients. Patients without H. pylori infection who develop duodenal ulcers should be assessed for use of aspirin or NSAIDs; Zollinger-Ellison syndrome, a condition characterized by the excessive secretion of acid in the stomach; and other factors or conditions, which may cause duodenal ulcers. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Medicine
Subject: Health care industry
ISSN: 0002-9343
Year: 1991
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Is Helicobacter pylori a cause of duodenal ulcer? a methodological critique of current evidence
Article Abstract:
Although Helicobacter pylori (HP), a microorganism, has been implicated in duodenal ulcer disease (DU; ulcers of the first part of the small intestine), causation has not actually been shown, and many people with HP do not have DU. HP is also associated with chronic active gastritis (CAG; inflammation of the stomach). To evaluate whether HP causes DU and CAG, or whether HP is merely present in the stomach when CAG and DU develop (as the result of some other cause), a review was carried out of eight carefully selected clinical studies on HP and DU. These studies were conducted between 1985 and 1990. Criteria for evaluating epidemiologic evidence were used to analyze the data. In all cases, a strong association was shown between HP and DU. Six studies were cross-sectional and can not, by design, provide information concerning the temporal relationship between HP and DU. Evidence for biologic gradient (a dose-response effect) or temporality (temporal relationship between the assumed cause and its effect) was not shown in any study reviewed. An appropriate study design for showing cause and effect is suggested, but it is recognized that such a study would be difficult to carry out. At present, HP can not be said to be a cause of DU; evidence suggests that CAG is associated with DU in some way, and that HP moves into the inflamed area. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Medicine
Subject: Health care industry
ISSN: 0002-9343
Year: 1991
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