[Diseases in the esophagus, stomach and duodenum: is Helicobacter pylori to blame?]

To evaluate a) how many of symptomatic patients referred for upper endoscopy have active H. pylori infection, b) the correlation between the indications for upper endoscopy and endoscopic diagnosis and c) the association between H. pylori and organic disease in the upper gastrointestinal tract.

This is a prospective study on 562 symptomatic patients referred for upper gastrointestinal endoscopy. The criteria for inclusion were symptoms from the upper gastrointestinal tract but patients taking anticoagulation medication were excluded. All patients who had received H. pylori eradication therapy were excluded from the final analysis. Biopsies were obtained from both the antrum and body of the stomach for CLO testing as well as for histological evaluation for H. pylori.

For final analysis 458 patients (81.5%) were evaluable, 76 patients (13.5%) were excluded who came for evaluation after H. pylori eradication and 28 patients (5%) were also excluded due to inadequate information. Of 458 patients, 220 (48%) tested CLO positive, there of 122 women (46%) and 98 men (50.5%). The correlation between indication for referral for upper endoscopy and final endoscopic diagnosis was poor, where peptic ulcer disease was clearly overrated. Active H. pylori infection was most often diagnosed among patients with peptic ulcer disease, particularly duodenal ulcer (82%) and less often gastric ulcer (60%). Patients with gastritis and duodenitis had H. pylori diagnosed in 57% of the cases.

H. pylori was diagnosed in 48% of patients with symptoms from the upper gastrointestinal tract. Of all patients with peptic ulcer disease H. pylori was diagnosed in only 69% of the cases, which is lower than previous studies have indicated. The correlation between indication for endoscopy and the endoscopic diagnoses is rather poor. It is important to perform diagnostic endoscopy early in order to select the best initial treatment for the patient.