Could gastric histology be a useful marker for making decision on Helicobacter pylori eradication therapy in patients with dyspepsia?

Arruda, Silvana Gonçalves Brito de; Forones, Nora Manoukian; Jucá, Norma Thomé; Barros, Kátia Simone Cezário de

doi:10.1590/s0004-28032009000300013

Cited by 6 publications

(8 citation statements)

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“…29 In the present study, intestinal metaplasia was seen in 4 (3.9%) patients of non ulcer dyspepsia on gastric biopsy and was also of mild grade. This is in concordance with other studies which reported intestinal metaplasia in 2.5% 19 and 8% 21 NUD patients.…”

Section: Discussionsupporting

confidence: 93%

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Gastric mucosal biopsies in non ulcer dyspepsia: A histopathologic study

2015

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Background: Non-ulcer dyspepsia (NUD) is a major health problem and one of the most common causes of morbidity and economic loss. The aim of the study was to determine the pattern of gastric mucosal histopathologic alterations and frequency of Helicobacter pylori in patients with NUD.Materials and Methods: Patients presenting to Gastroenterology Out Patient Department over a period of one year with symptoms of dyspepsia but without any endoscopic lesion were taken up for the study and evaluated by obtaining two gastric mucosal biopsy specimens each from antrum and body mucosa. The specimens were processed and examined histologically using the updated Sydney system.Results: Gastric biopsies from 102 patients (63 females and 39 males) with NUD were studied. Histological examination of gastric mucosal biopsies showed that 82.3% of NUD patients had histopathological features of gastritis. Chronic infl ammation was present in 84 (82.3%), activity was seen in 63 (61.7%), glandular atrophy was seen in 10 (9.8%) and intestinal metaplasia was seen in 4 (3.9%) patients with NUD on gastric biopsy. Maximum number of patients with NUD had Sydney score of less than 5 (68.6%).H pylori were identifi ed on gastric mucosal biopsies in 49 (48.0%) patients with NUD based on H & E and Geimsa stained sections.Conclusion: NUD is a clinical problem which occurs in both sexes in all age groups; prevalence being low below 20 years of age. Patients with this condition have a high frequency of gastric mucosal inflammation and H pylori infection.Asian Journal of Medical Sciences Vol.7(2) 2015 80-84

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Section: Discussionsupporting

confidence: 93%

“…This is consistent with other studies where histopathological features of gastritis was observed in the range of 70-92% in patients with NUD. [18][19][20] Chronic gastritis alone was seen in 21(20.5%) patients, both acute and chronic gastritis in 63 (61.7%) and 18 (17.6%) patients had normal mucosal biopsies in the present study.…”

Section: Discussionmentioning

confidence: 59%

Gastric mucosal biopsies in non ulcer dyspepsia: A histopathologic study

2015

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“…This result was in agreement with observations by Nwokediuko and Okafor, 17 who found that only 29.3% of patients with functional dyspepsia had normal histology of gastric biopsies by histological examination. This result is also in accordance with which was reported by Arruda et al, 18 who studied 40 dyspeptic patients (28 women and 12 men) with endoscopically normal stomach and found 72.5% of patients with gastritis by histological examination. This emphasizes the role of biopsy in examining a case of dyspepsia as the normal endoscopy does not rule out underlying pathology.…”

Section: Discussionsupporting

confidence: 93%

Histopathological Assessment of Dyspepsia in the Absence of Endoscopic Mucosal Lesions

Dawod

Emara

2010

Euroasian Journal of Hepato-Gastroenterology

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IntroductionDyspepsia is a common symptom with an extensive differential diagnosis. Endoscopy alone may miss serious mucosal lesions in about 15 to 30% of cases. The aim was to determine histopathological features of gastric and duodenal mucosal biopsies in patients with dyspepsia and normal looking upper gastrointestinal (GI) endoscopy.Materials and methodsOne hundred and five adult patients presenting with dyspepsia with no endoscopic mucosal lesions in the upper GI tract were included. Gastric biopsy specimens according to Sydney–Houston system for grading gastritis and biopsy from duodenum were taken. The histopathological features were graded according to the Sydney–Houston system classification for grading gastritis.ResultsThe histological lesions were found in 65.7% (69 out of 105 endoscopy free dyspeptic patients). Chronic inflammation was the commonest finding. Neutrophilic activity, glandular atrophy, and mild degree of intestinal metaplasia were present in 27, 45, and 6 patients (22.8, 42.8, and 5.7% respectively). Helicobacter pylori was present in 54 patients with histopathological lesions and in 6 patients without histopathological lesions, and the difference was significant (p = 0.045).ConclusionThe endoscopic diagnosis of dyspepsia correlated poorly with histopathological findings. The histopathological examination allowed detection and grading of gastric pathology in dyspepsia with normal endoscopy and the commonest finding was the moderate chronic gastritis.How to cite this articleDawod HM, Emara MW. Histopathological Assessment of Dyspepsia in the Absence of Endoscopic Mucosal Lesions. Euroasian J Hepato-Gastroenterol 2016;6(2):97-102.

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“…The intensity of lesions observed by histology has also been proposed as a criterion to select dyspeptic patients to be treated by eradication therapy. According to this criterion, one-quarter of the dyspeptic patients with moderate to severe gastritis would be treated in Brazil [15].…”

Section: Histologymentioning

confidence: 99%

Diagnosis of Helicobacter pylori Infection

et al. 2010

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If we had to give a general view of the articles published in the year 2010, we should conclude that the evidence in the year 2010 suggests that, also in Helicobacter pylori diagnosis, "the devil is in the details". In this sense, different studies suggested that skipping citric acid pretreatment or local validation or reducing the (13) C-urea dose markedly decreases the accuracy of the urea breath test. The studies also implied that, even between monoclonal stool tests, there are large differences between the marketed tests. Finally, even histology does not work adequately in patients with gastric cancer or extensive areas of intestinal metaplasia. In these cases, specific gastric sites should be biopsied to improve the reliability of histology.

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Could gastric histology be a useful marker for making decision on Helicobacter pylori eradication therapy in patients with dyspepsia?

Cited by 6 publications

References 24 publications

Gastric mucosal biopsies in non ulcer dyspepsia: A histopathologic study

Gastric mucosal biopsies in non ulcer dyspepsia: A histopathologic study

Histopathological Assessment of Dyspepsia in the Absence of Endoscopic Mucosal Lesions

Diagnosis of Helicobacter pylori Infection

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