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Helicobacter pylori-negative duodenal ulcer
T J Borody1, L L George, S Brandl
1Centre for Digestive Diseases, Sydney, Australia.
The American Journal of Gastroenterology
|September 1, 1991
Summary
Most duodenal ulcers are caused by Helicobacter pylori (HP) gastritis. However, about 6% of duodenal ulcers are HP-negative, indicating other causes like NSAIDs or infections, requiring further investigation for proper treatment.
Area of Science:
- Gastroenterology
- Microbiology
Background:
- Helicobacter pylori (HP) is the primary cause of chronic duodenal ulcers (DU).
- A subset of duodenal ulcer patients are negative for HP infection.
Purpose of the Study:
- To investigate the frequency and underlying causes of HP-negative duodenal ulcers.
Main Methods:
- Endoscopic diagnosis of duodenal ulcer in 302 patients.
- Histology, culture, and urease testing to detect HP infection.
- Analysis of patient history for NSAID and antibiotic use, and other potential etiologies.
Main Results:
- 94% of patients had HP-positive gastritis; 6% (18/302) were HP-negative.
- Nonsteroidal anti-inflammatory drugs (NSAIDs) were the most frequent cause in HP-negative cases (8/18).
- Other causes included recent antibiotic use, Crohn's disease, Gastrospirillum hominis infection, and pancreatic carcinoma.
Conclusions:
- While HP is the main cause, approximately 6% of duodenal ulcers have unusual, HP-negative etiologies.
- Identifying the specific cause of HP-negative duodenal ulcers is crucial for effective therapeutic management.