Abstract
Helicobacter pylori (H. pylon) infection of the stomach may be harmful both to the mucus layer and the underlying cells which might impair defence against noxious agents such as NSAIDs. The aim of this study was to evaluate the prevalence of H. pylori and gastric lesions in NSAID-treated patients.
Methods: In 132 patients treated with NSAID and upper gastrointestinal symptoms (63 males, 69 females, mean age 49 years, range 28-59), endoscopic investigation of the antral and corporal mucosa, including H. pylori testing (urease and histology) was performed.
Results:
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1
H. pylori was found in 95 patients (72%);
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2
In this group, ulcers were found in 73 cases (77%), 33 in the duodenal bulb (35%), 27 in the prepyloric region (29%) and 13 (13%) in the gastric body.
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3
In the H. pylori-negative group (37), ulcers were found in 19 patients (51%), 7 (19%) in the duodenal bulb, 8 (21.6%) in the prepyloric region and 4 (10.8%) in the gastric body.
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4
In the H. pylori-positive group, a predominant finding was chronic superficial active gastritis, with focal intestinal metaplasia (mostly complete) and atrophy in 25 (24%) of ulcer and in 26 (23%) of non-ulcer cases; in 33 (29%) in prepyloric and in 38 (53%) in gastric body ulcer.
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5
Chronic superficial gastritis was not found in the H. pylori-negative group.
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6
Endoscopie findings in non-ulcer cases showed a higher proportion of more-severe lesions — bleeding areas — in the H. pylori-positive group, whereas less-severe lesions (erosions, bleeding, spots) were more often present in the H. pylori-negative group. Frank bleeding occurred in 20% of the H. pylori-positive and in 19% of the H. pylori-negative group, in the first group predominantly due to ulcer.
Conclusions: NSAID-related ulcers occur more frequently in H. pylori-positive cases, probably due to impaired defence. This seems to justify H. pylori testing and adequate treatment of positive cases in NSAID gastropathy.
Correspondence
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Jablonska, M., Chlumská, A. (1997). Impaired Gastric Mucosal Defence in Helicobacter Pylori-Related Conditions. In: Mózsik, G., Nagy, L., Pár, A., Rainsford, K.D. (eds) Cell Injury and Protection in the Gastrointestinal Tract. Springer, Dordrecht. https://doi.org/10.1007/978-94-011-5392-8_17
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DOI: https://doi.org/10.1007/978-94-011-5392-8_17
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