Helicobacter pylori: types of diseases, diagnosis, treatment and causes of therapeutic failure

Acute upper gastrointestinal lesions have a multifactorial etiology but, regardless of the cause, they are related to mucosal barrier destruction. Since Helicobacter pylori induces a superficial chronic gastritis with the infiltration of neutrophils in the mucosa, it was speculated that Helicobacter pylori infection could also cause bleeding lesions. The diagnosis, the proper treatment and the revaluation of its effectiveness actually represent the prophylaxis of some diseases such as peptic ulcer, gastric lymphoma or mucosa-associated lymphoid tissue (MALT) and gastric cancer. These diseases and their severe complications are life-threatening for the patient. Periodic renewal of the treatment and knowing the real causes of Helicobacter pylori resistance to various antibiotics must always be understood by the clinician. Although Helicobacter pylori treatment fails in about 20% of cases, moral support of the patient by the clinician, information about possible evolutional complications of Helicobacter pylori infection, and periodic evaluation of the patient during therapy, are important tools on which the therapeutic success depends

The Association between Acute Coronary syndrome and Anti Helicobacter Pylori Antibody

Background: Coronary artery disease is the main cause of mortality in developing countries like Iran.recently Due to failure of classic risk factors to completely explain Cause of acute coronary syndrome other risk factors, for example infection diseases are under investigation. One of these infectious agents is Helicobacter pylori which have been investigated in numerous studies. This study was designed to study of Association between Acute Coronary syndrome and Anti Helicobacter Pylori Antibody. Materials and Methods: This case-control study was performed on 300 hospitalized patients with Acute Coronary syndrome include UA and MI who refered to emam khomaini hospital and 300 hospitalized patients in fatemi and alawi hospital without of history of coronary heart disease and then Anti Helicobacter Pylori Antibody was examined by ELISA. Using chi-square and t- test the results were analyzed and P value less then 0.05 was considered significant. Results: 79 patients (26/3%) were seropositive, and 122(40/6%) seronegative in case group, different between Helicobacter pylori seropositivity and risk factor of Acute Coronary syndrome.sigmificant Association was found between Helicobacter pylori is case and control group. Conclusion: This study showed that prevalence of Helicobacter pylori infection in patients with acute coronary syndrome was higher and Helicobacter pylori infection could be e risk factor for Acute Coronary syndrom

Is there any Association between Helicobacter Pylori Infection and Laryngeal Carcinoma

Objective: To investigate the possible role of Helicobacter pylori as a cause of squamous cell carcinoma of larynx in a case-control study in an otolaryngology ward at an academic university. Subjects and Methods: A total of 65 patients with laryngeal cancer and 65 matched cancer-free controls underwent esophagogastroduodenoscopy and biopsy of antral and body regions of the stomach for evaluation of Helicobacter pylori infection. Results:The proportion of subjects with a positive rapid urease test for gastric infection was similar between the two groups (49.2 % in cases vs. 40% in controls). However, a positive rapid urease test for body was less frequently seen in patients with laryngeal cancer whereas a positive rapid urease test for antrum was significantly higher (P=0.04). Conclusion: Our study failed to show Helicobacter pylori as one of the etiologies of laryngeal cancer. However, it supported the hypothesis that colonization of Helicobacter pylori only in the gastric body might have a protective effect against laryngeal cancer with decreasing gastric acid while antral Helicobacter pylori, increasing gastric acid due to G cell hyperplasia, may be a predisposing factor for laryngeal cancer, with acid reflux as a possible underlying etiology. Keywords: Helicobacter pylori - laryngeal cancer - rapid urease test - gastric acid - esophagogastroduodenoscop

HELICOBACTER PYLORI INFECTION IN CHILDREN

AbstrakFaktor risiko infeksi Helicobacter pylori adalah tinggal di negara berkembang, kondisi sosial ekonomi yang rendah, jumlah anggota keluarga yang banyak, etnik dan genetik. Tatalaksana dan diagnosis Helicobacter pylori belum memuaskan karena adanya resistensi antibiotik pada pasien Helicobacter pylori. Kami melaporkan seorang pasien perempuan usia 8 tahun 6 bulan yang terinfeksi Helicobacter pylori. Diagnosis ditegakkan berdasarkan anamnesis, pemeriksaan fisik, dan hasil laboratorium. Pasien diduga terinfeksi Helicobacter pylori karena mengalami nyeri perut berulang. Dari laboratorium didapatkan serologi IgG Helicobacter pylori positif. Pada hasil endoskopi biopsi ditemukan kuman Helicobacter pylori. Pasien mendapat therapi eradikasi lini pertama untuk infeksi Helicobacter pylori yaitu amoksisilin, klaritromisin dan omeprazol selama dua minggu. Setelah dua minggu pengobatan keluhan pasien tidak ada.Kata kunci: Helicobacter pylori, anak, nyeri perut berulangAbstractRisk factors for acquiring Helicobacter pylori infection include residency of developing country, poor socioeconomic conditions, crowded family, and possibly an ethnic or genetic as predispositions. The diagnosis and management Helicobacter pylori has not been satisfied yet, however, there is problem of increasing resistancy antibiotic due to Helicobacter pylori. Objective: We report a 8 year and 6 month old girl who suffered from Helicobacter pylori. The diagnosis was based on history, clinical finding, and laboratory work-up. Suspicion on the presence of Helicobacter pylori was started when the girl had recurrent abdominal pain. Serology IgG Helicobacter pylori was positive and we had done endoscopic examination and biopsy. Therapy this patient was first line eradication Helicobacter pylori which give amoxicillin, clarithromycin and omeprazole for two weeks. There are no sympthoms after two weeks therapyKey word: Helicobacter pylori, children, recurrent abdominal painLAPORAN KASU

Duodenal ulcer, Helicobacter pylori and gastric secretion

This study investigated the possibility that Helicobacter pylori is an aetiological factor in the pathogenesis of duodenal ulcer. The aim was to establish whether subjects with duodenal ulcer with Helicobacter pylori had a maximal gastric secretion that was measurably different from that of subjects with duodenal ulcer without Helicobacter pylori. Because Helicobacter pylori is a common infection of individuals without duodenal ulcer, it was felt important to control the observations in the duodenal ulcer group with similar observations in subjects without duodenal ulcer. In 62 subjects with dyspepsia attending for upper gastrointestinal endoscopy, maximal gastric secretion was measured in the 11 non-duodenal ulcer subjects without Helicobacter pylori 20 non-duodenal ulcer subjects with Helicobacter pylori, 21 duodenal ulcer subjects with Helicobacter pylori and 10 duodenal ulcer subjects without Helicobacter pylori Thus the incidence of duodenal ulcer was about 50% whether or not Helicobacter pylori was present. Several tests were used for identification of Helicobacter pylori. In both groups, duodenal ulcer and non-duodenal ulcer, the presence of Helicobacter pylori was associated with a smaller gastric secretion than that in the absence of Helicobacter pylori In subjects with duodenal ulcer the reduction in secretion was 15% and in non-duodenal ulcer it was 18%. Regression analysis indicated that in the absence of Helicobacter pylori there was a strong positive correlation between dose of chronic smoking and maximal gastric secretion in both duodenal ulcer and non-ulcer subjects. However, in the non-duodenal ulcer and duodenal ulcer subjects in whom Helicobacter pylori present, there was no correlation. The enhancing effect of tobacco was apparently nullified by infection with Helicobacter pylori This finding made it unlikely that the association between duodenal ulcer, Helicobacter pylori and reduced gastric secretion was due to a cumulation of aetiological effect between acid and organism. These results lend support to the hypothesis that Helicobacter pylori is not a significant factor in the aetiology of duodenal ulcer. The subjects were followed up and the various details of the follow up studies were consistent with this view

Biofilm dental, un reservorio para Helicobacter Pylori en pacientes con gastritis crónica: Dental Biofilm, a reservoir for Helicobacter Pylori in patients with chronic gastritis

Objectives: To determine the prevalence of helicobacter pylori in dental biofilm in patients with chronic gastritis in the gastroenterology service of Hospital María Helper. Methods: A cross-sectional descriptive observational study was carried out, working with a population of patients attended in 1 calendar year, of the of which only 100 patients met the inclusion and exclusion criteria. It has been made a collection for the variables age, sex, helicobacter pylori in dental biofilm and helicobacter pylori in gastric mucosa biopsy. The relative frequency of Helicobacter Pylori in dental biofilm in patients with chronic gastritis and so exploratory a chi2-square test was performed for helicobacter in dental biofilm and helicobacter in gastric mucosa biopsy. Results: A prevalence of helicobacter pylori was detected in dental biofilm from 66% in patients with chronic gastritis, in turn 48% of the total in this group I present a positive helicobacter pylori in gastric mucosa biopsy. From the patients positive for helicobacter pylori in gastric mucosa 83.33% presented positivity in dental biofilm. An association was found for the variables helicobacter pylori in dental biofilm and helicobacter pylori in gastric mucosa biopsy with a p value = 0.002. Conclusions: A high prevalence of helicobacter pylori was found in biofilm of patients with chronic gastritis and an association between dental biofilm and gastric mucosa biopsy for helicobacter pylori.Objetivos: Determinar la prevalencia de helicobacter pylori en biofilm dental en pacientes con gastritis crónica en el servicio de gastroenterología del Hospital María Auxiliadora. Métodos: Se realizó un estudio observacional descriptivo transversal, trabajándose con una población de pacientes atendidos en 1 año calendario, de los cuales solo 100 pacientes cumplieron con criterios de inclusión e exclusión. Se realizó una recolección para las variables edad, sexo, helicobacter pylori en biofilm dental y helicobacter pylori en biopsia de mucosa gástrica. Se calculó la frecuencia relativa de Helicobacter Pylori en biofilm dental en pacientes con gastritis crónica y de manera exploratoria se realizó una prueba de chi2 cuadrado para helicobacter en biofilm dental y helicobacter en biopsia de mucosa gástrica. Resultados: Se detectó una prevalencia de helicobacter pylori en biofilm dental de 66% en los pacientes con gastritis crónica, a su vez un 48% del total de este grupo presento helicobacter pylori positivo en biopsia de mucosa gástrica. De los pacientes positivos para helicobacter pylori en mucosa gástrica un 83,33% presento positividad en biofilm dental. Se encontró asociación para las variables helicobacter pylori en biofilm dental y helicobacter pylori en biopsia de mucosa gástrica con un valor p = 0.002. Conclusiones: Se encontró una prevalencia elevada de helicobacter pylori en biofilm dental de pacientes con gastritis crónica y una asociación entre el biofilm dental y biopsia de mucosa gástrica para helicobacter pylori

A study of Helicobacter pylori infection in diabetes mellitus

Background: Helicobacter pylori is the most common bacterial infection in human beings. The aim was to study the association of Helicobacter pylori infection in patients of diabetes mellitus. Design of the study was observational analytic cross sectional study.Methods: A total of 69 subjects were studied. Of these 30 were non diabetics and 39 were diabetics, with disease duration more than 1 year. The serological diagnosis of H. pylori was made by Anti- Helicobacter pylori antibody test. Antral biopsies of all diabetic patients were taken during endoscopy and subjected to histological examination.Results: The mean age for the diabetics was 48.9±9.86 years and that of non-diabetics was 47.9±9.16 years. The majority of the subjects belonged to fifth and sixth decades. There was conspicuous male preponderance in both the diabetics and the nondiabetics group, more attributable to the selection bias. Serum samples of all the subjects were tested for the presence of IgG against Helicobacter pylori. Helicobacter pylori was positive in 40% of non-diabetics and 64.1% of diabetics X2 = 3.96, p value=0.047 (p<0.05) i.e. the prevalence of Helicobacter pylori in diabetics is significantly higher than that in non-diabetics. Histological examination of antral biopsies (known to be the gold standard method of diagnosing Helicobacter pylori) was performed in all diabetics and comparison of the type of diabetes, duration of diabetes, and level of glycaemia and complications of diabetes were made in patients of diabetes with and without Helicobacter pylori. This study showed patients with IDDM had higher positivity (75%) than those of NIDDM (67.6%). The mean duration of diabetes with Helicobacter pylori group was 7.85+3.93 years, and higher than that of diabetics without Helicobacter pylori which was 5.83±2.52. The mean fasting blood sugar was 192±60.3 mg/dl in diabetics with Helicobacter pylori group and was higher than that of diabetics without Helicobacter pylori group which was 167±37.1mg/dl. The mean post prandial blood sugar in diabetics with Helicobacter pylori group was 318±78.4mg/dl and was more than that of diabetics without Helicobacter pylori group in whom it was 280±49.7mg/dl. The two diagnostic modalities viz serological and histological identification of Helicobacter pylori correlated well with each other. It was observed that serological diagnosis by Anti- Helicobacter pylori antibody test is 80% sensitive and 75% specific.Conclusions: The prevalence of Helicobacter pylori is higher in diabetics than the non-diabetics. The prevalence of Helicobacter pylori infection had no significant correlation with duration of diabetes, type of diabetes, glycaemia levels of diabetics and complications of diabetics. The serological diagnosis of H. pylori was made by Anti- Helicobacter pylori antibody test, by Biochem Immuno systems ITALIA SPA ELAGEN Helicobacter pylori IgG Kit. This ELISA technique is 80% sensitive and 75% specific

Extragastroduodenal conditions associated with Helicobacter pylori infection

Helicobacter pylori is a Gram-negative bacterium that is considered a causative agent of peptic ulcer disease, gastric lymphoma, and gastric carcinoma. Helicobacter pylori triggers an intense leucocyte infiltration of the gastric submucosa, an action which is mediated by pro-inflammatory cytokines. This pathogenetic mechanism is common to many other diseases and consequently, Helicobacter pylori seroprevalence has also been investigated in other diseases. It is now known that Helicobacter pylori seropositivity is associated with various cardiovascular, respiratory, extragastroduodenal digestive, neurological, dermatological, autoimmune, and growth disorders. Although the precise role of Helicobacter pylori is unknown in these diseases, the organism can be eradicated using simple and reliable drug regimens. The conditions associated with Helicobacter pylori seropositivity are highlighted in this article.published_or_final_versio

Review article: the global emergence of Helicobacter pylori antibiotic resistance.

BackgroundHelicobacter pylori is one of the most prevalent global pathogens and can lead to gastrointestinal disease including peptic ulcers, gastric marginal zone lymphoma and gastric carcinoma.AimTo review recent trends in H. pylori antibiotic resistance rates, and to discuss diagnostics and treatment paradigms.MethodsA PubMed literature search using the following keywords: Helicobacter pylori, antibiotic resistance, clarithromycin, levofloxacin, metronidazole, prevalence, susceptibility testing.ResultsThe prevalence of bacterial antibiotic resistance is regionally variable and appears to be markedly increasing with time in many countries. Concordantly, the antimicrobial eradication rate of H. pylori has been declining globally. In particular, clarithromycin resistance has been rapidly increasing in many countries over the past decade, with rates as high as approximately 30% in Japan and Italy, 50% in China and 40% in Turkey; whereas resistance rates are much lower in Sweden and Taiwan, at approximately 15%; there are limited data in the USA. Other antibiotics show similar trends, although less pronounced.ConclusionsSince the choice of empiric therapies should be predicated on accurate information regarding antibiotic resistance rates, there is a critical need for determination of current rates at a local scale, and perhaps in individual patients. Such information would not only guide selection of appropriate empiric antibiotic therapy but also inform the development of better methods to identify H. pylori antibiotic resistance at diagnosis. Patient-specific tailoring of effective antibiotic treatment strategies may lead to reduced treatment failures and less antibiotic resistance

Effect of Helicobacter Pylori Eradication on Extent of Duodenal Gastric Metaplasia and Grade of Gastritis

The extent of the regression of duodenal gastric metaplasia (DGM) after the eradication of Helicobacter pylori infection is controversial. Therefore, we decided to assess the degree of DGM before, sex weeks and one year after H. pylori eradication. 105 consecutive Helicobacter pylori positive patients with endoscopically proven duodenal ulcer, with DGM and Helicobacter pylori infection were recruited for this study. The diagnosis of Helicobacter pylori infection was based on CLO-test and histology, and DGM was assessed on four bulb biopsies taken before, sex weeks and one year after Helicobacter pylori eradication. Histological assessment of Helicobacter pylori associated gastritis was performed according to the Sydney classification. Follow up study on 98 patients before, six weeks and one year after the eradication of Helicobacter pylori showed that the mean extent of DGM did not change significantly after eradication and did not differ when compared with 14 patients with persisting infection. Our results show that the inflammatory process related to Helicobacter pylori does not play the main role in the development of DGM