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HELICOBACTER PYLORI INFECTION AND TREATMENT OUTCOME IN AN URBAN AUSTRALIAN POPULATION
Author(s) -
Lam Vincent W. T.,
Trinh Linh K.,
Wilson Robert B.
Publication year - 2006
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/j.1445-2197.2006.03836.x
Subject(s) - medicine , gastroenterology , helicobacter pylori , rapid urease test , campylobacter , histology , biopsy , gastritis , biology , bacteria , genetics
Background: To examine the rate of Helicobacter pylori infection in a group of symptomatic patients using rapid urease test and antral histology and report on their treatment outcomes. Methods: From a single‐surgeon series in a tertiary teaching hospital, 200 consecutive symptomatic patients undergoing their first diagnostic upper gastrointestinal endoscopy during 2003–2004 were included in this retrospective audit. Campylobacter‐like organism (CLO) test results were compared with the results of conventional histological examination plus Giemsa staining. Eradication rates and demographic data were collected. Results: One hundred and seventy‐nine of 200 (89.5%) patients had antral biopsies for histology and for CLOtest. The CLOtest was positive in 31% (56/179) of patients. Thirty‐two of 56 (57%) patients had an early‐positive CLOtest (<24 h). The remaining 43% (24/56) of patients had a late‐positive CLOtest (>24 h). Histological examination of the antral biopsy showed evidence of H. pylori in 28/56 (50%) patients with a positive CLOtest. H. pylori eradication therapy was prescribed in 51/56 (91%) patients with a positive CLOtest. Forty‐five of 51 (88%) of these patients had a subsequent urea breath test. Urea breath test was positive in 17/45 (29%) patients after H. pylori eradication therapy was prescribed. Conclusion: Rate of H. pylori in this series of symptomatic patients was 31%. As nearly half of the CLOtests became positive after 24 h, we suggest that the CLOtest should be re‐examined 24 h after gastroscopy. Standard antral histology and CLOtest were in agreement in only 50% of cases, suggesting that the CLOtest is a more sensitive test. The failure rate of 29% for initial H. pylori eradication therapy reinforces the need for follow up after treatment.