Abstract
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.
Original language | English |
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Pages (from-to) | 710-714 |
Number of pages | 5 |
Journal | ANZ Journal of Surgery |
Volume | 76 |
Issue number | 8 |
DOIs | |
Publication status | Published - 1 Aug 2006 |
Externally published | Yes |
Keywords
- Diagnosis
- Gastroscopy
- Helicobacter pylori
- Urease