OBJECTIVE: To evaluate whether some duodenal ulcers (DU) classified as idiopathic according to standard criteria may be causally related to isolated duodenal colonization by H. pylori. METHODS: We studied consecutive ambulatory patients undergoing upper gastrointestinal endoscopy in a secondary care setting. Gastric and duodenal biopsies for diagnosing H. pylori infection were taken from all patients. Independently from the findings of duodenal biopsies, DU patients without gastric infection were classified as having idiopathic ulcers, and underwent urea C13 breath test and subsequent eradication therapy. Endoscopy was repeated 6 months after eradication treatment. RESULTS: Among 608 DU patients, 42 (6.9%) were classified as idiopathic: 24 (3.9%) were free from gastric and duodenal infection (group A) and 18 (3.0%) (group B) had isolated duodenal colonization. Urea C13 breath test was positive in one (4.2%) group A patient and in 3 (16.7%) group B patients. After eradication therapy, DU were detected in 14 out of 20 group A patients (70%) (four patients did not perform control endoscopy) and in 2 group B patients (11.1%): OR 18.66, 95% CI 3.23-107.82, P = 0.002. The difference was still detectable after multivariate analysis taking into account possible confounding factors: OR 15.79, 95% CI 2.48-100.53, P = 0.001. CONCLUSIONS: Isolated duodenal colonization by H. pylori is detectable in a substantial proportion of patients with so-called idiopathic DU, and eradication therapy is effective in these patients.

Pietroiusti, A., Forlini, A., Magrini, A., Galante, A., & Bergamaschi, A. (2008). Isolated H-Pylori duodenal colonization and idiopathic duodenal ulcers. THE AMERICAN JOURNAL OF GASTROENTEROLOGY, 103(1), 55-61 [10.1111/j.1572-0241.2007.01506.x].

Isolated H-Pylori duodenal colonization and idiopathic duodenal ulcers

PIETROIUSTI, ANTONIO;FORLINI, ANTONIO;MAGRINI, ANDREA;GALANTE, ALBERTO;
2008

Abstract

OBJECTIVE: To evaluate whether some duodenal ulcers (DU) classified as idiopathic according to standard criteria may be causally related to isolated duodenal colonization by H. pylori. METHODS: We studied consecutive ambulatory patients undergoing upper gastrointestinal endoscopy in a secondary care setting. Gastric and duodenal biopsies for diagnosing H. pylori infection were taken from all patients. Independently from the findings of duodenal biopsies, DU patients without gastric infection were classified as having idiopathic ulcers, and underwent urea C13 breath test and subsequent eradication therapy. Endoscopy was repeated 6 months after eradication treatment. RESULTS: Among 608 DU patients, 42 (6.9%) were classified as idiopathic: 24 (3.9%) were free from gastric and duodenal infection (group A) and 18 (3.0%) (group B) had isolated duodenal colonization. Urea C13 breath test was positive in one (4.2%) group A patient and in 3 (16.7%) group B patients. After eradication therapy, DU were detected in 14 out of 20 group A patients (70%) (four patients did not perform control endoscopy) and in 2 group B patients (11.1%): OR 18.66, 95% CI 3.23-107.82, P = 0.002. The difference was still detectable after multivariate analysis taking into account possible confounding factors: OR 15.79, 95% CI 2.48-100.53, P = 0.001. CONCLUSIONS: Isolated duodenal colonization by H. pylori is detectable in a substantial proportion of patients with so-called idiopathic DU, and eradication therapy is effective in these patients.
Pubblicato
Rilevanza internazionale
Articolo
Esperti anonimi
Settore MED/44 - Medicina del Lavoro
English
Con Impact Factor ISI
amoxicillin; clarithromycin; omeprazole; adult; aged; antibiotic therapy; article; bacterial colonization; controlled study; duodenum biopsy; duodenum ulcer; family history; female; follow up; gastrointestinal endoscopy; Helicobacter infection; Helicobacter pylori; human; idiopathic disease; major clinical study; male; priority journal; smoking; statistical analysis; stomach biopsy; urea breath test; Anti-Bacterial Agents; Anti-Ulcer Agents; Biopsy; Breath Tests; Colony Count, Microbial; Duodenal Ulcer; Female; Follow-Up Studies; Helicobacter Infections; Helicobacter pylori; Humans; Intestinal Mucosa; Male; Middle Aged; Prognosis; Proton Pump Inhibitors; Retrospective Studies; Urea
Pietroiusti, A., Forlini, A., Magrini, A., Galante, A., & Bergamaschi, A. (2008). Isolated H-Pylori duodenal colonization and idiopathic duodenal ulcers. THE AMERICAN JOURNAL OF GASTROENTEROLOGY, 103(1), 55-61 [10.1111/j.1572-0241.2007.01506.x].
Pietroiusti, A; Forlini, A; Magrini, A; Galante, A; Bergamaschi, A
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2108/38741
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