A comparative study of helicobacter pylori in patients undergoing upper gastrointestine endoscopy in benign and malignant conditions of upper gastrointestine tract in meenakshi medical college hospital & research institute

Abstract

AIMS & OBJECTIVES To study the prevalence of Helicobacter pylori in patients with dyspepsia undergoing upper Gastrointestine endoscopy in Meenakshi Medical College Hospital & Research Institute and to study the association of Helicobacter pylori with Acid peptic diseases & Malignant conditions of upper Gastro intestine tract MATERIALS & METHODS 389 cases of dyspepsia, studied clinically from 2009 to 2012, were subjected to upper gastro-intestinal endoscopy, during which 4 biopsies, two each from the antrum and the pathological areas were taken. Two biopsy specimens, one of the antral area and the other of the pathological finding were immediately subjected to Rapid urease test. Positive test for Helicobacter pylori was indicated by change in colour of the medium from yellow to pink or red. The other two biopsy specimens were sent for routine histopathology and special staining with Giemsa stain. The case was taken as Helicobacter pylori positive when the rapid urease test and/or histopathological examination were positive. RESULTS Out of 389 patients, with mean age of 41.8 years 172 patients were diagnosed to have been infected with Helicobacter pylori (44.21%). Out of 49 patients, with gastric & duodenal ulcers, 37 patients were infected with Helicobacter pylori (75.51%). 22 out of 25 patients(88%) with duodenal ulcers and 10 out of 14 patients(71.4%) with gastric ulcers were positive for H. pylori while only 8 out of 10 patients(80%) with gastric cancer were positive for H. pylori. Out of remaining 340 patients out of which 43 were found to be positive for Helicobacter pylori infection (33.85%) and 213 patients with gastritis/ duodenitis, out of which, 92 were infected with Helicobacter pylori (43.19%), there were 127 patients with normal endoscopic findings. CONCLUSION In this study, we found that Helicobacter pylori was consistently associated with peptic ulcer disease and malignant conditions of upper GI tract, which is in broad agreement with the studies done earlier. Thus we conclude that, Helicobacter pylori infection may have a major role in the etio pathogenesis of peptic ulcer disease and malignant conditions of upper GI tract here appear to be no significant association between Helicobacter pylori infection and unexplained dyspepsia. Hence, we recommend eradication of the bacteria only in patients positive for the bacterium, who have peptic ulceration. The cases positive by rapid urease test were found positive from biopsy also.