Helicobacter pylori infection, gastric metaplasia in the duodenum and the relationship with ulcer recurrence.
Objective: To study the prevalence of Helicobacter pylori (H. pylori) infection and gastric metaplasia (GM) in the duodenum a large group of patients with duodenal ulcer was evaluated to determine whether these factors are related to the number of ulcer recurrences.Methods: Three hundred and seven p...
| Publicado en: | European Journal of Gastroenterology & Hepatology Vol. 12; no. 12; pp. 1295 - 1299 |
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| Autores principales: | , , , |
| Formato: | research Journal Article |
| Publicado: |
Lippincott Williams & Wilkins
2000 Dec
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=138559483&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 138559483 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 0954691X 8CE jtl: European Journal of Gastroenterology & Hepatology issn: 0954691X maglogo: N pubinfo: dt: 2000 Dec vid: 12 iid: 12 pid: 5086 pub: Lippincott Williams & Wilkins place: Baltimore, Maryland artinfo: ui: 138559483 138559483 NLM11192318 138559483 10.1097/00042737-200012120-00006 NLM11192318 138559483 ppf: 1295 ppct: 4 formats: tig: atl: Helicobacter pylori infection, gastric metaplasia in the duodenum and the relationship with ulcer recurrence. aug: au: Gisbert, J P Blanco, M Cruzado, A I Pajares, J M affil: Department of Gastroenterology, University Hospital of La Princesa, Madrid, Spain sug: subj: Helicobacter Pylori Gastritis Pathology Helicobacter Infections Epidemiology Helicobacter Infections Pathology Duodenal Ulcer Pathology Gastric Mucosa Pathology Gastroscopy Middle Age Comorbidity Duodenal Ulcer Epidemiology Duodenal Ulcer Microbiology Adult Prospective Studies Prevalence Endoscopy, Gastrointestinal Female Risk Factors Multivariate Analysis Probability Gastritis Microbiology Confidence Intervals Biopsy, Needle Male Recurrence Gastritis Epidemiology Human Validation Studies Comparative Studies Evaluation Research Multicenter Studies Scales Middle Aged: 45-64 years Adult: 19-44 years Female Male ab: Objective: To study the prevalence of Helicobacter pylori (H. pylori) infection and gastric metaplasia (GM) in the duodenum a large group of patients with duodenal ulcer was evaluated to determine whether these factors are related to the number of ulcer recurrences.Methods: Three hundred and seven patients diagnosed by endoscopy as having active duodenal ulcers were studied. At endoscopy, all patients had gastric biopsies taken for histology, the rapid urease test and culture. Three duodenal biopsies were also taken and processed for histology (haematoxylin & eosin, Giemsa, Warthin-Starry, and PAS stain).Results: GM and H. pylori in the duodenum was identified in 73% (68-78%) and 66% (60-71%) of the cases, respectively. All patients with H. pylori in the duodenum also had GM at this location, while areas with GM but without H. pylori were described. The kappa statistic for concordance between GM and H. pylori at the duodenum was 0.82. The prevalence of GM and H. pylori, depending on the number of ulcer recurrences, was: 1st episode, 34% and 27%, respectively; 2nd episode, 84% and 80%; and > or = 3rd episode, 90% and 79% (P < 0.001 when comparing 1st vs 2nd or > or = 3rd episode). In the multivariate analysis, age and number of ulcer recurrences correlated both with GM and with H. pylori in the duodenum. Chronic duodenitis was demonstrated in all duodenal biopsies, 87% being active chronic duodenitis. H. pylori in the duodenum was more frequent in patients with active duodenitis (73%) than in those with inactive duodenitis (13%) (P < 0.001).Conclusions: Patients with recurrent ulcer disease have a higher prevalence of both GM and H. pylori infection in the duodenum, suggesting that these two factors are related with the chronicity and recurrence of duodenal ulcer disease. H. pylori infection in the duodenum always appears in areas of GM, although GM is not necessarily colonized by the organism. H. pylori infection cannot be excluded based only on the results of duodenal biopsies, as false negative results at this area are frequent. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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