ROLE OF HELICOBACTER PYLORI IN DYSPEPSIA WITH AND WITHOUT NSAIDs INTAKE AND THE EFFECT OF THERAPY

Abstract

In 600 patients with dyspepsia with and without NSAIDs intake and/or CLD, the overall incidence of H. pylori was 92%. Diagnosis of H. pylori was made by ELISA finger prick test, rapid urease test, histopathology and culture methods. The highest incidence of H. pylori (97.6%) was found in peptic ulcer and the lowest incidence (85%) in NUD. CLD and NSAIDs does not constitute an independent risk factor for contracting H. pylori. Duodenal ulcer was diagnosed in 104 patients (17.3%) of which 101 {97.1%)werefoundtobe colonized with H. pylori. High colonization density of H. pylori was found in patients with DU as well as in patients with dysplasia and intestinal metaplasia with high significant correlation between the degree of colonization and activity of gastritis. This fmding enforces the role played by this organism in the aetiopathogenesis of DU and adds a further confirmatory evidence that patients with high grade of colonization are more liable for changes in the surface mucosa with its possible consequences. H. pylori positive patients were randomly allocated to one of two treatment strategies. Either dual therapy with omeprazole (or lansoprazole) and nitazoxanide (or roxithromycin) or triple therapy with lansoprazole, roxithromycin and metronidazole{or nitazoxanide). Patients treated with triple therapy of lanzop., roxithro. and nitazoxanide showed almost 92% cure rate judged by breath test (in a subset of patients) 4 to 6 weeks after therapy. The• relapse rate of H. Pylori was found to be 2.7% (2/73). It is concluded, therefore, that H. pylori is widely prevalent in patients with dyspepsia in Egypt and H. pylori eradication is a stable phenomenon over time.