Page 33 - World Journal of Laparoscopic Surgery

ORIGINAL ARTICLE
Role of Helicobacter pylori in Chronic Abdominal Pain

and Endoscopy-suggested Gastritis

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Aniket P Patil , Mansing N Ghatge , Saurabh P Parab , Sharang S Kulkarni 4
AbstrAct
Aim and background: Helicobacter pylori (H. pylori) infection can cause chronic gastritis and gastric malignancy. Upper gastrointestinal endoscopy
is performed to assess the symptoms of abdominal pain but endoscopy alone is not confirmatory. Therefore, either pathological evaluation
of biopsies of mucosa or detection of urease in the mucosa by rapid urease test (RUT) produces accurate diagnosis. The study aimed to assess
the role of H. pylori infection among patients with chronic abdominal pain and endoscopy-suggested chronic gastritis and also to evaluate the
association of endoscopic findings and RUT.
Materials and methods: The prospective randomized study was performed on 50 patients with clinical findings suggestive of chronic gastritis
or abdominal pain of unknown etiology. Data regarding patient history and routine physical and clinical examination were recorded. Upper
gastrointestinal endoscopy was performed in all patients. Organs including the esophagus, stomach, and duodenum were examined for
abnormality and biopsy was performed at various sites of the affected organ. The obtained specimen from biopsy was subjected to RUT.
Results: Endoscopic finding suggested gastritis in 6% (n = 38) of the patients among which 31 patients were RUT positive. A significant
association was found between endoscopic findings and RUT (p = 0.013). Patients of 31–40 years of age (n = 11) and males were found to be
more commonly affected as indicated by a positive reaction to RUT (n = 27).
Conclusion: RUT facilitates rapid and accurate diagnosis of H. pylori infection, and along with endoscopy, can be used in the diagnosis of
H. pylori infection in chronic gastritis.
Clinical significance: Early diagnosis of H. pylori is essential to formulate early and appropriate clinical strategies for better management of the
patient. RUT is a well-known diagnostic test that is rapid, cheap, and simple. It detects urease in or on gastric mucosa produced by the bacteria.
Keywords: Diagnostic test, Gastric mucosa, Helicobacter pylori, Prospective studies, Urea, Urease.
World Journal of Laparoscopic Surgery (2022): 10.5005/jp-journals-10033-1488

IntroductIon 1–4 Department of General Surgery, DY Patil Medical College, DY Patil
Globally the prevalence of chronic gastritis and gastric ulceration Education Society (Deemed to be University), Kolhapur, Maharashtra,
is high. Helicobacter pylori (H. pylori) infection is the main cause India
of chronic active gastritis and has complications such as gastric Corresponding Author: Aniket P Patil, Department of General Surgery,
adenocarcinoma and mucosa-associated lymphoid tissue DY Patil Medical College, DY Patil Education Society (Deemed to be
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lymphoma (MALT lymphoma). The prevalence of the infection University), Kolhapur, Maharashtra, India, Phone: +91 7588698398,
in a developed country is 10% and is as high as 80% in developing e-mail: aniketdr12@gmail.com
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countries such as India. How to cite this article: Patil AP, Ghatge MN, Parab SP.
The associated complication with H. pylori infection is due to Role of Helicobacter pylori in Chronic Abdominal Pain and
untreated chronic gastritis. Hence, identification of the etiology of Endoscopy-suggested Gastritis. World J Lap Surg 2022;15(1):31–34.
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gastritis is of great value in eliminating carcinoma. Furthermore, Source of support: Nil
the rate of mucosal damage caused by H. pylori is unpredictable, and Conflict of interest: None
infection is always transmissible. It is recommended that whenever
a H. pylori infection is detected, it should be treated unless there is a
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compelling reason that would mitigate that choice. The diagnosis MAterIAls And Methods
H. pylori infection plays an important role in effective treatment. The Upon obtaining institutional ethics committee approval, the
tests used in diagnosis are classified as invasive and noninvasive. prospective randomized study was carried out over a period of two
Invasive tests are endoscopy-based include histology, rapid urease test years. Sample size was calculated using the formula:
(RUT), culture, and polymerase chain reaction, whereas noninvasive
tests including serological, urea breath test, and stool antigen 2 × z (1 p )
− p
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test. Early diagnosis of H. pylori is essential to formulate early and N = 2
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appropriate clinical strategies for better management of the patient. d
RUT is a well-known diagnostic test that is rapid, cheap, and simple. It Calculated sample size was n = 43.
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detects urease in or on gastric mucosa produced by the bacteria. The In this study n = 50 patients with endoscopically proved
study aimed to assess the role of H. pylori infection among patients with features suggestive of mucosal changes, chronic gastritis, and
chronic abdominal pain and endoscopy suggested chronic gastritis patients with abdominal pain with normal clinical and laboratory
and to evaluate the association of endoscopic findings and RUT. findings were included and informed consent was obtained.

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