Cure of <i>Helicobacter pylori</i> infection in the elderly: effects of eradication on gastritis and serological markers

Pilotto, Alberto; Mario, F. Di; Franceschi, Marilisa; Leandro, Gioacchino; Soffiati, Giuliano; Scagnelli, Mariuccia; Bozzola, L.; Valerio, G.

doi:10.1046/j.1365-2036.1996.88260000.x

Cited by 47 publications

(41 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These findings were in agreement with recent studies demonstrating that, in elderly subjects, HP infection is associated with clinically important gastroduodenal pathologies [24,25]. HP eradication reduces both short-and long-term symptomatology, gastritis activity and ulcer recurrences [26,27].…”

Section: Discussionsupporting

confidence: 82%

Lack of association between Helicobacter pylori infection and extracardiac atherosclerosis in dyspeptic elderly subjects

et al. 1999

View full text Add to dashboard Cite

Background: there are conflicting data on the association between Helicobacter pylori (HP) infection and cardiovascular diseases. Aim: to determine if there is an association between gastric HP infection and atherosclerosis of cerebral or peripheral arteries in elderly subjects. Methods: 90 dyspeptic elderly subjects had upper gastro-intestinal endoscopy and the gastroduodenal pathology was identified. HP infection was confirmed by gastric histology and the rapid urease test. Vascular ultrasonography of extracranial cerebral arteries and leg arteries was performed to evaluate (i) the presence of an atherosclerotic lesion, (ii) the total length of all plaques documented and (iii) the number of arteries with atherosclerotic lesions. Statistical analysis was by the x 2 test, Yates's corrected x 2 test, the Mann-Whitney test and logistic regression. Results: 59 subjects were HP-positive. These had a higher prevalence of peptic ulcer disease (P = 0.01) and higher serum levels of IgG anti-HP antibodies (P = 0.0001), but no significant differences in the number of atherosclerotic lesions, the total length of the plaques or the number of arteries with lesions. No significant association of HP positivity was found with diabetes mellitus, hypertension, cigarette smoking or coronary heart disease, nor with serum concentrations of HDL-cholesterol, fibrinogen, triglycerides or glucose. Conclusions: elderly dyspeptic subjects with gastric HP infection had significantly more peptic ulcer disease but no more atherosclerotic lesions than those who were HP-negative. Atherosclerosis was not associated with HP infection. In this cross-sectional study of elderly patients with dyspepsia, no association between HP infection and extracardiac atherosclerosis was found.

show abstract

Section: Discussionsupporting

confidence: 82%

Lack of association between Helicobacter pylori infection and extracardiac atherosclerosis in dyspeptic elderly subjects

et al. 1999

View full text Add to dashboard Cite

show abstract

“…A recent short-term (3 months of follow-up) study demonstrated that in elderly patients anti-HP treatment was well tolerated and highly effective concerning both the eradication rate and the improvement in chronic gastritis activity [12]; however, no data has been reported regarding the long-term clinical outcome of elderly patients treated for HP infection. This is the first study aimed at evaluating the effects of HP eradication on the long-term clinical outcome, i.e.…”

Section: Discussionmentioning

confidence: 99%

The Long-Term Clinical Outcome of Elderly Patients with Helicobacter pylori-Associated Peptic Ulcer Disease

et al. 1998

View full text Add to dashboard Cite

The objective of this study was to evaluate the long-term efficacy of Helicobacter pylori (HP) eradication treatment in elderly patients with HP-associated peptic ulcer. A total of 56 subjects, 25 affected with gastric ulcer (GU, 9 males, 16 females, mean age 77.8 years, range 67–93) and 31 with duodenal ulcer (DU, 19 males, 12 females, mean age 76.5 years, range 65–87) were confirmed to be HP-positive by gastric histology and the rapid urease test. All patients were then consecutively treated with omeprazole for 4 weeks plus one or two antibiotics for 1 week as anti-HP treatment. Clinical checkups were then performed every 3 months for 1 year for the evaluation of symptoms and clinical recurrences. Endoscopy with gastric biopsies was repeated after 1, 3 and 12 months for the evaluation of ulcer healing, HP infection and chronic gastritis activity. Statistical analysis was performed by means of the Student t test for unpaired data, the Fisher exact test (two-tailed), and the McNemar χ² test. After 4 weeks of treatment, endoscopy confirmed healing of the ulcer in all patients, regardless of the treatment used to cure HP infection. Two months after the end of therapy, a total of 44 patients were HP-negative and 12 patients were still HP-positive. During the 1-year follow-up period 1/44 (2.2%) of the HP-eradicated patients and 5/12 (41.6%) of the still HP-positive patients suffered relapses (p = 0.001): the difference between the two groups remained statistically significant when patients were divided into the subgroups, GU (p = 0.01) and DU (p = 0.04). Two months after the end of therapy, there was still a significant reduction of symptoms both in HP-eradicated (p < 0.0000) and in HP-positive (p = 0.002) patients. After 1 year, however, there was a significantly decreased symptomatology only in HP-eradicated subjects (p < 0.0000) and not in patients still HP-positive. After both 2 months and 1 year of follow-up, chronic gastritis activity demonstrated a significant improvement only in HP-eradicated patients (p = 0.0000). In conclusion, the eradication of HP infection significantly improved the long-term clinical outcome of peptic ulcer disease in the elderly, reducing the recurrences of GU and DU, the patient’s symptomatology and the histological signs of chronic gastritis activity. The cure of HP infection is, therefore, strongly recommended in elderly patients with HP-associated peptic ulcer disease.

show abstract

“…53,54 H. pylori eradication reverses the serum PG elevation. 55,56 In general, the inflammatory process in the nonatrophic stomach is reported to induce a series of molecular events leading to the development of cancer, especially the diffuse type. 10,57,58 Thus, in the PG test-negative group, the basal level of activity of gastritis and cancer risk are considered to be no less in the H. pylori-eradicated subjects than in the noneradicated subjects.…”

Section: Discussionmentioning

confidence: 99%

Eradication of Helicobacter pylori prevents cancer development in subjects with mild gastric atrophy identified by serum pepsinogen levels

Yanaoka

Oka

Ohata

et al. 2009

Intl Journal of Cancer

129

117

View full text Add to dashboard Cite

A longitudinal cohort study was conducted in Helicobactor pyloriinfected middle-aged Japanese males to evaluate the preventive effects of H. pylori eradication on the development of gastric cancer according to the extent of chronic atrophic gastritis (CAG). The extent of CAG was monitored by baseline serum pepsinogen (PG) levels. We followed 3,656 subjects with persistent H. pylori infection and 473 subjects with successful H. pylori eradication for cancer development for a mean (SD) of 9.3 (0.7) years. Groups with and without extensive CAG were categorized based on PG test-positive criteria to detect extensive CAG of PG I 70 ng/ml and PG I/II ratio 3.0. During the study period, 5 and 55 gastric cancers developed in H. pylori-eradicated and the noneradicated subjects, respectively, indicating no significant reduction in cancer incidence after H. pylori eradication. Among the noneradicated subjects, 1,329 were PG test-positive and 2,327 were PG test-negative. Gastric cancer was confirmed in 30 and 25 subjects, respectively. Among subjects whose infection was eradicated, 155 were PG test-positive and 318 were PG test-negative. Of these subjects, gastric cancer was confirmed in 3 and 2 subjects, respectively. Significant reduction in cancer incidence after eradication was observed only in PG test-negative subjects (p < 0.05; log-rank test). The results of this study strongly indicate that cancer development after eradication depends on the presence of extensive CAG before eradication and that H. pylori eradication is beneficial to most PG test-negative subjects with mild CAG as defined by the aforementioned criteria. ' 2009 UICC

show abstract

Cure of Helicobacter pylori infection in the elderly: effects of eradication on gastritis and serological markers

Abstract: In the elderly, triple therapy with omeprazole+metronidazole+clarithromycin for 1 week is well tolerated and highly effective; anti-H. pylori antibody and PGC serum levels decrease soon after anti-H. pylori therapy only in patients cured of H. pylori infection.

Cited by 47 publications

References 0 publications

Lack of association between Helicobacter pylori infection and extracardiac atherosclerosis in dyspeptic elderly subjects

Lack of association between Helicobacter pylori infection and extracardiac atherosclerosis in dyspeptic elderly subjects

The Long-Term Clinical Outcome of Elderly Patients with Helicobacter pylori-Associated Peptic Ulcer Disease

Eradication of Helicobacter pylori prevents cancer development in subjects with mild gastric atrophy identified by serum pepsinogen levels

Contact Info

Product

Resources

About