Helicobacter Pylori: Prevalence in 352 Consecutive Patients with Dyspepsia

Abstract

At the Riyadh Armed Forces Hospital (RAFH), 352 patients had gastroscopy and from each, antral gastric biopsies were taken for identification of Helicobacter pylori, by urease test and histopathology. In 217 (61.64%) of these 352 patients, the histology specimens showed Helicobacter pylori in 73.68% of patients with duodenal ulcer, 70% of patients with gastric ulcers and gastric erosions, 61% of patients with duodenitis and 52% of patients with gastritis. Helicobacter pylori, previously known as Campylobacter, was first isolated in the human gastric mucosa by Warren and Marshall in 1983. 1 Helicobacter pylori has an etiological role in peptic ulcer disease and nonulcer dyspepsia.2-4 Helicobacter pylori secrete substances that mediate inflammation, cause tissue damage, and affect gastric secretory function.5 Helicobacter pylori infection is associated with alterations in surface mucous cells and with a marked inflammatory response consisting mainly of polymorphonuclear leukocyte infiltration. 6Helicobacter pylori colonization is now believed to be the major cause of type B gastritis.7 Helicobacter pylori is strongly associated with duodenal ulcer and the association varies between 80% to 100% from published reports. 8There are a few reports on Helicobacter pylori published from Saudi Arabia. [9][10][11][12][13] This study on the prevalence of Helicobacter pylori shows our experience at the Riyadh Armed Forces Hospital (RAFH), Riyadh. Patients and MethodsA total of 352 consecutive patients with dyspepsia (excluding patients with bleeding, tumors and those taking nonsteroidal anti-inflammatory drugs) had gastroscopy at the Gastroenterology Department, Riyadh Armed Forces Hospital, between January and June 1991G. The age of these patients range between 17 and 69 years (mean 48.2 years). The endoscopic diagnosis of gastritis or duodenitis was made if the mucosa was hyperemic, erythematous, congested or friable. A gastric or duodenal ulcer was diagnosed when an ulcer crater was noted.To determine the prevalence of Helicobacter pylori in these patients, three endoscopic biopsies (0.2 to 0.5 cm in size) were taken from the gastric antrum. One biopsy was placed immediately in the rapid urease test, 14Campylobacter-like organism (CLO or gel test) and examined at 10 minute intervals for the next six hours. If a definite pink color developed in the urease test, a positive result was recorded. The other two biopsies were placed in a buffered formalin saline and sent for histology, where paraffin sections were stained with hematoxylin and eosin for grading gastritis and with a May-Grünwald Giemsa method for showing bacteria according to the method of Whitehead et al 15 as modified by Marshall and Warren. 16 A positive Helicobacter pylori was recorded when a typical gram negative spiral bacteria was seen in the biopsy. In specimens where histology shows evidence of gastritis without Helicobacter, organisms are recorded as negative.

Endoscopical and Histopathological Interpretation of Gastritis in Nineveh Province

“…Mohamed AE et al (41) 1994 382 61.64% H. p antrum Giemsa stain Ibrahim BH et al (38) 1995 286 81.7% H. p antrum Hand E Abdul Jabbar B et al (26) 1997 81 75.3% H. p (antrum ) different stain Asa'ad SK et al (9) 2000 50 84%…”

“…19 Chronic infection with H. pylori may lead to glandular atrophy and IM. 16,18,24,25,[33][34][35][36][37][38][39][40][41] It had been shown that the frequency of H. Pylori infection increased with advanced age. 19,20 This in agreement with the result of this study, where the number of H. Pylori positive case increased with advanced age also.…”

Helicobacter pylori Infection in Endoscopic Biopsy Specimens of Gastric Antrum: Laboratory Diagnosis and Comparative Efficacy of Three Diagnostic Tests

“…Two antral biopsy specimens from each patient were fixed in 10% buffered formalin. Paraffin wax sections were cut after routine processing [4,10,11].…”

An Age- and Gender-Specific Analysis of H. Pylori Infection

“…The incidence rate of H. pylori infection in chronic gastritis from various regions of Saudi Arabia ranges from 50% to 96%. [3][4][5] Men and women are equally affected by the infection. Six commonly used tests to detect H. pylori are the histological examination, microbial culture, poly-merase chain reaction, rapid urease test, serology (ELISA) and 13C-urea breath test.…”