FONKSİYONEL DİSPEPSİLİ HASTALARDA HELICOBAKTER PYLORI ERADİKASYONUNUN EPİGASTRİK AĞRI SKORU İLE DEĞERLENDİRİLMESİ

Year 2019, , 233 - 238, 31.08.2019

Eylem Karatay , Özlem Gül Utku

https://doi.org/10.24938/kutfd.563210

Abstract

Amaç: Dispepsi,
erişkinlerin en sık görülen kronik hastalıklarından biridir. Dispepsi
tedavisinin maliyeti gelişmiş ülkelerde sağlık harcamalarının büyük bir kısmını
temsil etmektedir. Fonksiyonel dispepsi, multifaktöryel, etiyolojinde Helicobacter
pylori’nin suçlandığı
bir hastalıktır.
Bu çalışmada, “Fonksiyonel dispepsi” alt grubu olan epigastrik ağrı sendromlu
hastalarda Helicobacter pylori’nin eradikasyonunun epigastrik ağrı
şiddeti üzerine etkilerini semptomatik skorlama yaparak değerlendirmeyi
amaçladık.

Gereç ve Yöntemler: Fonsiyonel
dispepsi teşhisi konulan ve endoskopik biyopsilerinde Helicobacter pylori pozitifliği
tespit edilmiş 530 hasta çalışmaya dahil edildi. Hastalara dörtlü eradikasyon
tedavisi verildikten sonra hastaların semptom skorları 2. ve 6. ayda tekrar sorgulandı.

Bulgular: Çalışmaya 384
kadın (%73) ve 146 erkek (%27) hasta dahil edildi. Yaş ortalaması 39.8±10.6 /yıl
idi. Tedavi başlangıcından 2 ay sonra hastaların skorlarına bakıldığında 463 (%88)
hastada ağrı skorunda gerileme saptanırken, 67 (%12) hastanın ağrı skorunda
değişiklik olmadı. Tedavi sonrası ağrı skorlarında anlamlı düzeyde azalma
saptandı (p=0.001). İkinci ve 6. aydaki ağrı skorları karşılaştırıldığında; 6.
ayda ki ağrı skoru, başlangıç ve 2. aydaki ağrı skoruna göre daha düşük bulundu.

Sonuç: Hem iki hem de altıncı
aydaki, semptom skorlarındaki saptadığımız azalma eradikasyon oranları ile
ilişkili olabilir. Böylelikle gereksiz test yapılmasının önüne geçilerek
sağlık giderleri azaltılabilir. Bu bilgileri teyit edecek daha büyük sayıda
hasta grubu içeren ve randomize kontrollü çalışmalara ihtiyaç vardır.

Keywords

helikobakter pilori, fonksiyonel dispepsi

Evaluation of Helicobacter pylori Eradication on Functional Dyspepsia Using Epigastric Pain Score

Abstract

Objective: Dyspepsia is one of the
most common chronic illnesses of adults in the Western World. Not surprisingly,
the cost of dyspepsia treatment represents a large proportion of the healthcare
expenses in developed countries. Functional dyspepsia is a multifactorial
disease and Helicobacter
pylori
infection are thougt to be related to Functional dyspepsia. We aimed to
evaluate the effects of H. pylori eradication on epigastric
pain severity by symptomatic scoring.

Material and Methods: We enrolled 530 patients
which were diagnosed with functional dyspepsia and H. pylori positivity in endoscopic biopsies.
Symptom scores were questioned at 2th month and 6th month after the treatment.
All patients received standard quadruple therapy for 14 days.

Results: This
study was carried out on 384 female and 146 male patients. The mean age of the patients was
39.8±10.6 years. The scores of 463 (88%) patients showed regression after 2
months of treatment and 67(12%) patients had no differences in pain score. We observed
statistically significant decrease in pain scores after treatment (p=0.001). When
second and sixth month’s pain scores were compared, the pain score at the sixth
month was lower than the baseline and second month’s evaluation.

Conclusion: We found a decrease in
both 2th and 6th month symptom scores which may be related to eradication
rates. This finding can prevent unnecessary investigations and reduce medical
expenditures for H. pylori
eradication. But more randomized studies with large number of patients are
needed to confirm this information.

Keywords

Helicobacter pylori, functional dyspepsia, eradication

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