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Impact of Helicobacter pylori Infection and Microscopic Duodenal Histopathological Changes on Clinical Symptoms of Patients with Functional Dyspepsia

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Abstract

Aim

To evaluate the microscopic histopathological changes in duodenal tissue and its relationship to the severity of symptoms in patients with functional dyspepsia while taking the effect of Helicobacter pylori (H. pylori) infection into account.

Methods

Several gastric and duodenal biopsy specimens were obtained in 217 patients with functional dyspepsia and were evaluated for H. pylori infection and histopathological changes. Severity of symptoms was assessed by Leeds Dyspepsia Questionnaire (LDQ) and its relationship to histopathological changes and H. pylori infection status was assessed.

Results

Helicobacter pylori infection was associated with presence and severity of microscopic duodenitis (p < 0.001). In H. pylori-infected patients, the presence of microscopic duodenitis was independent of microscopic gastritis (p = 0.74). Severity of dyspepsia symptoms was not higher in H. pylori-infected patients than non-infected patients (p = 0.15), but in the presence of H. pylori infection and microscopic gastritis, microscopic duodenitis significantly worsened the LDQ symptom severity score (p < 0.001). In multivariate analysis, the odds of experiencing severe symptoms in patients with severe microscopic duodenitis was 2.22 times greater than in individuals with very mild, mild, or moderate duodenitis.

Conclusions

Microscopic duodenitis in H. pylori-infected patients may play a major role in producing and aggravating symptoms in FD patients and may be a determinant factor to consider in whether to treat H. pylori infection in functional dyspepsia.

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Conflict of interest

No conflict of interest exists in relation to the submitted manuscript and there was no source of extra-institutional commercial funding.

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Authors and Affiliations

  1. Department of Internal Medicine, Amir-Alam Hospital, School of Medicine, Tehran University of Medical Sciences, North Sa’adi Street, 13145-784, Tehran, Iran

    Seyed Amir Mirbagheri, Nasim Khajavirad, Mohammad Reza Ostovaneh & Seyed Mahmood Eshagh Hoseini

  2. Department of Pathology, Firoozgar Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran

    Nasser Rakhshani

  3. Department of Internal Medicine, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran

    Vahid Hoseini

Authors
  1. Seyed Amir Mirbagheri
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  2. Nasim Khajavirad
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  3. Nasser Rakhshani
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  4. Mohammad Reza Ostovaneh
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  5. Seyed Mahmood Eshagh Hoseini
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  6. Vahid Hoseini
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Corresponding author

Correspondence to Nasim Khajavirad.

Additional information

This study received approval from the local ethics committee.

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Mirbagheri, S.A., Khajavirad, N., Rakhshani, N. et al. Impact of Helicobacter pylori Infection and Microscopic Duodenal Histopathological Changes on Clinical Symptoms of Patients with Functional Dyspepsia. Dig Dis Sci 57, 967–972 (2012). https://doi.org/10.1007/s10620-011-1960-z

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  • DOI: https://doi.org/10.1007/s10620-011-1960-z

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