The clinical effect of Helicobacter pylorieradication with sequential therapy in patients with peptic ulcer or functional dyspepsia

Yıl 2013, Cilt: 21 Sayı: 3, - , 01.12.2013

Murat Sarıkaya Nesibe Taşer Bilal Ergül Zeynal Doğan Levent Filik

https://doi.org/10.17940/endoskopi.74794

Öz

Background and Aims: Helicobacter pylori infection plays an important role in the etiology of peptic ulcer and functional dyspepsia. Patients with peptic ulcer benefit from eradication of Helicobacter pylori, but there are fewer data related to this favorable response in patients with functional dyspepsia. In this study, we aimed to compare the benefit of sequential eradication therapy in patients with ulcer and non-ulcer dyspepsia who were diagnosed with Helicobacter pylori infection. Materials and Methods:166 patients were included in this study. Helicobacter pylori was checked via gastroscopic biopsy and rapid urease test. In all patients, the eradication status was checked by urea breath test in the 12 th week. Gastrointestinal symptom rating scale score was used to determine symptomatic improvement. Results:In the groups of ulcer and functional dyspepsia, a significant difference was determined in gastrointestinal symptom rating scale scores with sequential therapy (p

Anahtar Kelimeler

Helicobacter pylori, sequential therapy, functional dyspepsia, peptic ulcer

Peptik ülser ve fonksiyonel dispepside ardışık tedavi ile yapılan Helicobacter pylorieradikasyonunun klinik etkisi

Öz

Giriş ve Amaç:Helicobacter pylori enfeksiyonu peptik ülser ve fonksiyonel dispepsi etiyolojisinde önemli rol oynamaktadır. Helicobacter pylori eradikasyonu peptik ülserli hastalarda büyük fayda sağlamasına karşın fonksiyonel dispepsili hastalarda bu yarar üzerine daha az sayıda veriler bulunmaktadır. Bu çalışmada Helicobacter pylori enfeksiyonu saptanan ülserli ve nonülser dispepsili hastalarda ardışık eradikasyon tedavisinin yararını kar-şılaştırmayı amaçladık. Gereç ve Yöntem:Çalışmaya total 166 hasta dahil edildi. Hastalarda Helicobacter pylori pozitifliği gastroskopik biyopsi ve hızlı üreaz testi ile tespit edildi. Tüm hastalarda 12. haftada eradikasyon durumu üre nefes testi ile kontrol edildi. Semptomatik düzelme için Gastrointestinal Semptom Değerlendirme Skalası kullanıldı. Bulgular: Ülser ve fonksiyonel dispepsi gruplarının her ikisinde de ardışık tedavi ile Gastrointestinal Semptom Değerlendirme Skalası skorlarında anlamlı farklılık saptandı (p

Anahtar Kelimeler

Helicobacter pylori, ardışık eradikasyon tedavisi, fonksiyonel dispepsi, peptik ülser

Kaynakça

• García Rodríguez LA, Hernández-Díaz S. Risk of uncomplicated peptic ulcer among users of aspirin and nonaspirin nonsteroidal antiinflamma- tory drugs. Am J Epidemiol 2004;159:23-31.
• Kurata JH. Epidemiology: Peptic ulcer risk factors. Semin Gastrointest Dis 1993;4:2.
• Rosenstock SJ, Jİrgensen T, Bonnevie O, Andersen LP. Does Helico- bacter pylori infection explain all socio-economic differences in peptic ulcer incidence? Genetic and psychosocial markers for incident peptic ulcer disease in a large cohort of Danish adults. Scand J Gastroenterol 2004;39:823-9.
• Sung JJ, Kuipers EJ, El-Serag HB. Systematic review: the global inci- dence and prevalence of peptic ulcer disease. Aliment Pharmacol Ther 2009;29:938-46.
• Agreus L. Natural history of dyspepsia. Gut 2002:50(Suppl 4):iv2-9.
• Kitapçıoğlu G, Mandıracıoğlu A, Bor CC, Bor S. Overlap of symptoms of dyspepsia and gastroesophageal reflux in the community. Turk J Gastro- enterol 2007;18:14-9.
• Hernando-Harder AC, Franke A, Singer MV, Harder H. Functional dys- pepsia. New pathophysiologic knowledge with therapeutic implications. Medicina (B Aires) 2007;67:379-88.
• Mimidis K, Tack J. Pathogenesis of dyspepsia. Dig Dis 2008;26:194- 202.
• Malfertheiner P, Megraud F, O’Morain CA and European Helicobacter Study Group. Management of Helicobacter pylori infection--the Maas- tricht IV/ Florence Consensus Report. Gut 2012;61:646-64.
• Dimenas E, Glise H, Hallerback B, et al. Well-being and gastrointestinal symptoms among patients referred to endoscopy owing to suspected duodenal ulcer. Scand J Gastroenterol 1995;30:1046-52.
• Svedlund J, Sjodin I, Dotevall G. GSRS-a clinical rating scale for gas- trointestinal symptoms in patients with irritable bowel syndrome and peptic ulcer disease. Dig Dis Sci 1988;33:129-34.
• Kulich KR, Madisch A, Pacini F, et al. Reliability and validity of the Gas- trointestinal Symptom Rating Scale (GSRS) and Quality of Life in Reflux and Dyspepsia (QOLRAD) questionnaire in dyspepsia: a six-country study. Health Qual Life Outcomes 2008;6:12.
• Stein M, Ruggiero P, Rappuoli R, Bagnoli F. Helicobacter pylori CagA: From pathogenic mechanisms to its use as an anti-cancer vaccine. Front Immunol 2013;4:328.
• Kuipers EJ, Thijs JC, Festen HP. The prevalence of Helicobacter pylori in peptic ulcer disease. Aliment Pharmacol Ther 1995;9 (Suppl 2):59-69.
• O’Connor A, Molina-Infante J, Gisbert JP, O’Morain C. Treatment of He- licobacter pylori infection 2013. Helicobacter 2013;18 (Suppl 1):58-65.