Density of Helicobacter pylori Infection in Patients with Peptic Ulcer Perforation

Tokunaga, Yukihiko; Hata, Koichiro; Ryo, Junmei; Kitaoka, Akihiro; Tokuka, Atsuo; Ohsumi, Kiyosi

doi:10.1016/s1072-7515(98)00128-8

Cited by 53 publications

(37 citation statements)

References 26 publications

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“…In a group of 113 patients requiring surgical intervention due to ulcer disease, bacterial load was found to be closely associated with ulcer perforation, rather than with hemorrhagic or stenotic ulceration [48]. Additionally, heavy bacterial loads indicate an increased tendency and frequency of bleeding in preformed DUs, but do not predict the severity of a bleeding episode [49].…”

Section: High H Pylori Density In Complications Of Gastritismentioning

confidence: 99%

Bacterial Load and Degree of Gastric Mucosal Inflammation in <i>Helicobacter pylori</i> Infection

Varbanova

Malfertheiner²

2011

Dig Dis

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Helicobacter pylori induces an inflammatory immune response in the gastric mucosa. The degree of gastric mucosal inflammation and its topographic distribution are key factors in the diversity of H. pylori-related complications. Here we summarize substantial evidence reported in the literature concerning the impact of H. pylori density on gastric inflammation, the development of severe complications, and its relation to H. pylori suppression therapy. Most studies demonstrate a significant correlation between H. pylori density and the grade of acute and chronic inflammation, taking into account the limitations of each method for density assessment. Overall, high bacterial loads are associated with increased acute mucosal damage and long-term changes in the gastric mucosa. The influence of H. pylori density reduction on the improvement of gastric mucosal changes was observed in studies using ‘clearance’ therapies. Mucosal agents provoke a significant, but not persistent, reduction in gastritis activity. Treatments suppressing the density and virulence of H. pylori could become strategies to prevent H. pylori-associated disease in the future.

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Section: High H Pylori Density In Complications Of Gastritismentioning

confidence: 99%

Bacterial Load and Degree of Gastric Mucosal Inflammation in <i>Helicobacter pylori</i> Infection

Varbanova

Malfertheiner²

2011

Dig Dis

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“…A number of authors [5, 6, 7, 8]have shown that the implementation of this antimicrobe therapy leads to the ulcer disease being cured, and the percentages of relapse are very low [24]when compared to the high percentages of recurrence detected in patients receiving short treatments with agents that cure ulcers by means of gastric acidity inhibition [20, 23]. Controversy exists over the influence of H. pylori infection and ulcer perforation, since some authors [25, 26]consider that the perforation is caused by severe H. pylori infection. However, other studies [27, 28]find no correlation and report that, as occurs in our study, the eradication of H. pylori does not involve any significant reduction in the incidence of patients with perforated GDPU.…”

Section: Discussionmentioning

confidence: 99%

Has the Incidence of Perforated Peptic Ulcer Decreased over the Last Decade? / with Invited Commentary

Sánchez‐Bueno

Marín²,

Ríos³

et al. 2001

Dig Surg

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Background: The therapeutic use of new drugs for inhibiting gastric secretion together with Helicobacter pylori antimicrobe therapy has given rise to controversy over the current incidence of perforated peptic ulcer (gastroduodenal peptic ulcer, GDPU). The aim of this study is to analyze the incidence of ulcer perforation over the last 12 years in our health area and the influence of new medical treatments. Material and Methods: Our series includes 246 patients operated on for perforated peptic ulcer during a 12-year period (January 1987 to December 1998) in our health area. The mean patient age was 55.2 ± 18.1 (16–93) years, and there was a predominance of males (199/246; 80.9%). The ulcer was located fundamentally in the pylorus (48.3%) and duodenal bulb (39.1%), and the most frequent surgical technique was bilateral truncal vagotomy associated with pyloroplasty (85.3%). Results: During the 1987–1992 period, 152 patients underwent surgery, whereas 94 patients were operated on between 1993 and 1998, which reveals a statistically significant difference (p < 0.001). Furthermore, if we divide the study into four 3-year periods (1987–1989, 1990–1992, 1993–1995 and 1996–1998), we see that there were 74 and 78 GDPUs in the first two periods, with no statistical differences between each other, and 48 and 46 cases in the last two periods, also with no statistical differences between each other, but statistically significant when compared to the first two periods. Conclusion: The incidence of perforated GDPU has dropped by half over the last 6 years due fundamentally to the use of proton pump inhibitors.

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“…Ng et al 41 reported that 51 (70%) of 73 cases of perforated duodenal ulcer were infected with H pylori. If NSAID users were excluded, the number rose to 58 (80%).Tokunaga et al 42 reported H pylori in 92% of cases of perforated ulcer. The tissue density of infection was greater with perforation than with hemorrhage or obstruction.…”

Section: Conservative Managementmentioning

confidence: 99%

Non operative management of perforated peptic ulcer an algorithm approach.

Vijayakumar¹,

Mallikarjuna²,

Patil³

et al. 2013

Int J of Biomed & Adv Res

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Density of Helicobacter pylori Infection in Patients with Peptic Ulcer Perforation

Cited by 53 publications

References 26 publications

Bacterial Load and Degree of Gastric Mucosal Inflammation in <i>Helicobacter pylori</i> Infection

Bacterial Load and Degree of Gastric Mucosal Inflammation in <i>Helicobacter pylori</i> Infection

Has the Incidence of Perforated Peptic Ulcer Decreased over the Last Decade? / with Invited Commentary

Non operative management of perforated peptic ulcer an algorithm approach.

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