The spectrum of Helicobacter pylori in upper gastrointestinal disease

Helicobacter pylori has been recognized as a contributing factor in gastrointestinal disease. Yet, questions remain as to its clinical significance. This prospective study was done to determine the prevalence, distribution, clinical significance, and treatment response of H. pylori gastrointestinal infection. A total of 91 patients with upper gastrointestinal symptoms underwent 122 esophagogastroduodenoscopies (EGD). Biopsies were taken for H. pylori from the gastric fundus, body, antrum, prepylorus, and duodenal bulb; 45.3 per cent of patients with abdominal pain, 27.8 per cent with "heartburn," and 55.6 per cent with anemia/GI bleed had H. pylori infections. Pertaining to EGD findings: 54.2 per cent of patients with gastroduodenal ulcer, 56.4 per cent with gastritis/duodenitis, 37.5 per cent with esophagitis/esophageal ulcer, but only 17.6 per cent with normal findings had H. pylori infection. The distribution of H. pylori: fundus (53.3%); body (55.6%); antrum (85.4%); prepylorus (78.4%); duodenum (15.6%). Treatment for H. pylori was amoxicillin, metronidazole, colloid bismuth with an antisecretory drug. H. pylori was eradicated in 78.9 per cent of patients; 93.3 per cent of these patients had symptomatic improvement and/or ulcer healing. Using stepwise logistic regression, H. pylori eradication was an independent predictor of symptomatic improvement.