PREVALENCE OF HELICOBACTER PYLORI IN PATIENTS WITH DYSPEPSIA UNDERGOING UPPER GASTRO INTESTINAL ENDOSCOPY IN TERTIARY CARE HOSPITAL

BACKGROUND Acid peptic disease comprises of a wide spectrum of diseases, which cause considerable morbidity. Helicobacter pylori, a curved rod-shaped bacterium, has been consistently associated with patients suffering from acid peptic diseases, more in ulcer disease than in non-ulcer disease. Due to this high association, it is now believed that Helicobacter pylori plays an important role in the aetiopathogenesis of acid peptic disease. Several studies have revealed the association of Helicobacter pylori in 70-75 percent of patients with dyspepsia. Endoscopic studies have shown that, Helicobacter pylori is found in 80-100% of patients with duodenal ulcers and 60-75 per cent of patients with gastric ulcers. Amidst these profound variations proposed by many workers in the previous studies, we have attempted to study the prevalence of Helicobacter pylori in patients undergoing upper gastrointestinal endoscopy at our hospital and its association with acid-peptic disease. The objectives of this study were1. To study the prevalence of Helicobacter pylori in patients with dyspepsia undergoing upper gastrointestinal endoscopy. 2. To study the association of Helicobacter pylori with acid peptic Diseases. MATERIALS AND METHODS 344 cases of dyspepsia were studied clinically as per the proforma over a period of one and half years from July 2014 to October 2015. The inclusion and exclusion criteria were as follows; RESULTS Out of 344 patients, there were 224 male patients and 120 female patients, age ranging from 19 years to 60 years (Mean44.8). Out of 344 patients, 156 patients were diagnosed to have been infected with Helicobacter pylori (45.3%). CONCLUSION This was a prospective study conducted to determine the role of Helicobacter pylori in acid-peptic diseases. This study design was based on clinical study and endoscopic biopsy of gastric mucosa (and duodenal mucosa whenever necessary) in 344 patients with a history of dyspepsia. Endoscopy confirmed the diagnosis. Rapid urease test and Giemsa staining were conducted on endoscopy biopsy specimens and Helicobacter pylori positivity was based on either Rapid urease test and/or histopathological examination was positive. From the present study it is evident that, there was no specific symptom attributable to H. pylori infection. Helicobacter pylori infection is more common in males than females. Helicobacter pylori is consistently associated with peptic ulcer disease than non-ulcer dyspepsia, which is in broad agreement with the studies done earlier. Thus we conclude that, Helicobacter pylori infection may have a role in the aetiopathogenesis of peptic ulcer disease. There appears to be no significant association between Helicobacter pylori infection and dyspeptic cases with normal endoscopy. This finding does not exclude the possibility that a small undefined subset of infected individuals will have symptoms induced by the infection, but only large randomized trials will be able to establish this. Hence, we recommend eradication of the bacteria only in patients positive for the bacterium, who have peptic ulceration. We believe in, Peter C Robin’s dictum: “If a person with peptic ulcer disease is shown to have Helicobacter pylori, then eradication is indicated”.