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[Is there a relationship between digestive symptoms and H. pylori infection?]
D Boixeda1, J P Gisbert, C Martín de Argila
1Hospital Ramón y Cajal, Departamento de Medicina, Universidad de Alcalá de Henares, Madrid.
Unlabelled:
Infection by H. pylori is a common finding in the general population, its prevalence being higher in certain gastroduodenal diseases, particularly peptic ulcer and chronic gastritis. There is no general agreement on whether there is an association between digestive symptoms and the presence of H. pylori infection.
Aim:
To study whether there is an association between digestive symptoms and H. pylori infection.
Methods:
328 patients with symptoms related to the upper gastrointestinal tract who underwent a diagnostic endoscopy were studied. Symptoms were classified as: epigastric pain, epigastric burning, heartburn, nausea or vomiting, and dyspeptic symptoms suggestive of motility disorders. During endoscopy 3 biopsy samples were obtained from both the gastric antrum and the body of the stomach. One of the samples from each location was processed for microbiology studies, the other two for histological studies. A patient was considered to be infected by H. pylori when the organism was detected by microbiology and/or histology in any of the locations.
Results:
The mean age of patients was 47.3 + 15.2 years; the male/female ratio was 2.4/1. The endoscopic findings and the corresponding percentages of H. pylori infection were: normal endoscopy 55 (80%); gastritis 87 (82.7%); gastric ulcer 49 (100%); duodenal ulcer 88 (100%); duodenitis 20 (95%); gastric cancer 7 (100%), and gastrectomy 22 (71.4%). The frequency of the different clinical entities according to a positive or negative microbiological result was, respectively: epigastric pain (78.3/81.8%), epigastric burning (56.9/45.4%), heartburn (30.1/27.3%), nausea or vomiting (28.4/33.3%), and dyspeptic symptoms suggestive of motility disorders (53.8/54.5%); no significant differences were observed between the different groups.
Conclusion:
We found no association between digestive symptomatology and H. pylori infection, considering overall the most frequent gastrointestinal entities and the subgroup of patients with non-ulcer dyspepsia.