EVALUATION OF OCCURRENCE OF H. PYLORI INFECTION AND EFFICACY OF ERADICATION THERAPY IN PEPTIC ULCER DISEASE
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2017, Vol 6, Issue 80
Abstract
BACKGROUND Acid Peptic disease is one of the most common condition seen in routine practice. Symptoms may vary from vague abdominal pain and burning sensation to massive upper GI bleeding to Ulcer perforation. The endoscopic appearance of an ulcer provides important prognostic information. Endoscopic treatment in patients with high-risk stigmata results in improved outcomes. H. Pylori eradication therapy also improves quality of life. MATERIALS AND METHODS This is a retrospective observational study of 250 patients who underwent upper GI endoscopy for various reasons in GMCH, Miraj from April 2016 to Feb. 2017. Out of 250 cases, 101 patients who had peptic ulcers were studied. Detailed History, Patients’ symptoms and signs and recurrence rate were analysed. All post-endoscopy data and post-endoscopy management plans were analysed. RESULTS In this study, out of 250 (182 males, 68 females) patients who underwent upper GI scopy, it was observed that out of 250 cases, 101 patients (72 males and 29 females) had peptic ulcers. Out of 101 cases, 73 (72.27%) patients (52 males and 21 females) were positive and 28 (27.72%) were negative (20 males and 8 females) for H. pylori infection on rapid urease test. There was no significant association of H. pylori infection in relation to gender (P = 0.984). Eradication therapy given for 14 days to all 73 positive patients. After completion of eradication therapy, repeat endoscopy was done after 4 weeks and found that out of 73 positive cases, 65 (89.041%) patients who were kept on maintenance dose of PPI for 3 weeks were cured. Those 8 patients who were not cured were allowed to continue eradication therapy for 14 more days and then on PPI for 3 weeks. After completion of this treatment, they were found negative for H. pylori infection on repeat endoscopy. CONCLUSION Acid peptic disease is one of the most common condition encountered in routine practice. There was no statistical significance for occurrence of H. pylori infection in relation to gender (p = 0.984). Majority of cases can be managed with medical treatment. There is no recurrence if peptic ulcer disease is managed with eradication therapy along with elimination of all causative factors. Surgical treatment is needed for those who present with complications like intractable pain, massive upper GI bleeding, ulcer perforation, etc. For those who were positive for H. Pylori, eradication therapy (Omeprazole/Pantoprazole, Amoxicillin/Clarithromycin, Metronidazole/Ornidazole) with or without Bismuth subcitrate is the best treatment.
Authors and Affiliations
Prashant S. Dorkar, Prakash Gurav, Santosh Dalvi, Prachi Dharmadhikari, Anand H Devraj
Keywords
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- EP ID EP268165
- DOI 10.14260/jemds/2017/1227
- Views 98
- Downloads 0
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