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ORIGINAL ARTICLE
Year : 2014  |  Volume : 4  |  Issue : 2  |  Page : 91-95

The prevalence of Helicobacter pylori in acid peptic disease


Department of Surgery, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, Punjab, India

Correspondence Address:
Manan S Malhotra
H. No. 91/8, c/o Naveen Cloth Emporium, Bhut Nath Street, Mandi (H.P.) - 175001
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2278-9596.143085

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Background: Acid peptic disease is a common problem world over resulting from imbalance of acid and pepsin present in gastric secretions. It encompasses many conditions, including gastritis and peptic ulcer with dyspepsia being a common complaint. Prevalence of H. pylori is high in developing countries and low in developed countries. We study the prevalence of H. pylori and its association with age, sex, and dietary factors in patients with acid peptic disease. Materials and Methods: The study was conducted on 200 patients >= 18 yrs visiting SGRD hospital with complaints of dyspepsia, in a period of 2 years. Patients who refused endoscopy, who were medically unstable, those with suspected perforation, those with deranged coagulation profile, patients with history of intake of PPIs, bismuth compounds, antibiotics (metronidazole, amoxicillin, clindamycin, clarithromycin) in previous 1 week, those suffering from cholecystitis, cholelithiasis, pancreatitis, were excluded from the study. Patients were advised to stop all anti-ulcer drugs, antibiotics and bismuth containing drugs at least 1 week prior to the study. Informed consent was taken from the patients. These patients were subjected to detailed history and physical examination. A detailed questionnaire which collected presenting complaints, sociodemographic characteristics, dietary habits, smoking and drinking habits, history of regular intake of NSAIDs, any other co-morbid condition present, and abdominal ultrasonography findings, was filled. On upper GI endoscopy, gastric antral biopsies were taken and subjected to rapid urease test using a commercially available test kit. The results were noted and analyzed statistically. Results: Overall prevalence of H. pylori came out to be 80.5%. It was more in males than females. Prevalence increased with increasing age and was highest (90.9%) in age group >70 yrs. Most common dyspeptic symptom was fullness after meals. Prevalence was seen more in non-vegetarians (83.7%) than in vegetarians (78.1%) but statistically insignificant. Chronic gastritis was most common endoscopic finding with 96.1% prevalence of H. pylori associated with it and this was significant statistically (P < 0.05). Association with peptic ulcer did not come out to be statistically significant (P > 0.05). Conclusions: Prevalence of H. pylori is very high in our part of the world and rapid urease test presents an easy, accurate, cost-effective method for its detection. No significant association seen with gender, dietary factors, NSAIDs, smoking and alcohol intake. Chronic gastritis shows a significant association, while both duodenal and gastric ulcer did not show any significant association with H. pylori. So, taking into account the high prevalence, and association with chronic gastritis, treatment should be offered to every patient with such complaints and findings on endoscopy.


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