Abstracts
The diagnostic yield of various tests for Helicobacter pylori infection in patients on acid-reducing drugs, such as proton pump inhibitors (PPI) and histamine-2 receptor blocker (H2RB), was compared. Seventy-four consecutive patients on acid-reducing drugs were enrolled: 34 (46%) were on PPIs, 20 (27%) were on H2RBs and 20 (27%) were not on medications. For those patients on PPIs, RUT and histology results from antrum were negative in 28 (82%) and 17 (50%) patients, respectively (OR: 4.7; 95% CI: 1.4–16.6; P = 0.004), while those from the corpus were negative in was 28 (82%) and 18 (53%) patients, respectively (OR: 4.4, 95% CI: 1.3–15.5; P = 0.006). For patients on H2RBs, RUT and histology results from the antrum were negative in 12 (60%) and six (30%) patients, respectively (OR: 3.5; 95% CI: 0.8–16.1; P = 0.05), while those from the corpus were negative in 12 (60%) and nine (45%) patients, respectively (OR: 1.8; 95% CI: 0.4–7.8; P = 0.342). For those patients on PPIs, the diagnostic yield of both RUT and histology was reduced from both the antrum and corpus. In these patients, PCR for H. pylori is more sensitive than RUT and histology.
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References
Malfertheiner P, Megraud F, O’Morain C, Hungin AP, Jones R, Axon A, Graham DY, Tytgat G (2002) European Helicobacter Pylori Study Group (EHPSG). Current concepts in the management of Helicobacter pylori infection in the Maastricht 2–2000 Consensus Report. Aliment Pharmacol Ther 16:167–180
Ng FH, Lai KC, Wong BC, Wong WM, Wong SY, Chow KC, Yuen ST, Leung SY, Lam SK (2002) [13C]-urea breath test without prior fasting and without test meal is accurate for the detection of Helicobacter pylori infection in Chinese. J Gastroenterol Hepatol 17:834–838
Chang MC, Chang YT, Sun CT, Wu MS, Wang HP, Lin JT (2002) Quantitative correlation of Helicobacter pylori stool antigen (HpSA) test with 13C-urea breath test (13C-UBT) by the updated Sydney grading system of gastritis. Hepatogastroenterology 49:576–579
Morio O, Rioux-Leclercq N, Pagenault M, Corbinais S, Ramee MP, Gosselin M, Bretagna JF (2004) Prospective evaluation of a new rapid urease test (Pronto Dry) for the diagnosis of Helicobacter pylori infection. Gastroenterol Clin Biol 28:569–573
Garner A, Fadlallah H, Parsons ME (1996) 1976 and all that – 20 years of antisecretory therapy. Gut 39:784–786
Sturm AW, van der Pol R, Smits AJ, van Hellemondt FM, Mouton SW, Jamil B, Minai AM, Sampers GH (1997) Over-the-counter availability of antimicrobial agents, self-medication and patterns of resistance in Karachi, Pakistan. J Antimicrob Chemother 39:543–547
Yakoob J, Jafri W, Abid S, Jafri N, Abbas Z, Hamid S, Islam M, Anis K, Shah HA, Shaikh H (2005) Role of rapid urease test and histopathology in the diagnosis of Helicobacter pylori infection in a developing country. BMC Gastroenterol 25:5:38
Yakoob J, Jafri N, Jafri W, Zaman S, Chuan Bian L, Islam M, Hussainy AS, Zaman V (2004) Polymerase chain reaction in the detection of Helicobacter pylori infection. J Coll Phys Surg Pak 14:153–156
Abid S, Hussain T, Rabbani F, Ahmed A (2003) Seroprevalence and risk factors for H. pylori. A population based study. Helicobacter 8:A395
Price AB (1991) The Sydney System: histological division. J Gastroenterol Hepatol 6:209–222
Van Zwet AA, Thijs C, Kooistra-Smid, Schirm J, Snijder JAM (1993) Sensitivity of Culture compared with that of Polymerase chain reaction for detection of Helicobacter pylori from antral biopsy samples. J Clin Microbiol 31:1918–1920
Fox JG, Dewhirst FE, Shen Z, Feng Y, Taylor NS, Paster BJ, Ericson RL, Lau CN, Correa P, Araya JC, Roa I (1998) Hepatic Helicobacter species identified in bile and gallbladder tissue from Chileans with chronic cholecystitis. Gastroenterology 114:755–763
Verdu EF, Armstrong D, Idstrom JP, Labenz J, Stolte M, Dorta G, Borsch G,Blum AL (1995) Effect of curing Helicobacter pylori infection on intragastric pH during treatment with omeprazole. Gut 37:743–748
Brunner G, Creutzfeldt W (1989) Omeprazole in the long-term management of patients with acid-related diseases resistant to ranitidine. Scand J Gastroenterol Suppl 166:101–105
Festen HP (1994) Prevention of duodenal ulcer relapse by long term treatment with omeprazole. Scand J Gastroenterol 201:39–41
Logan RP, Walker MM, Misiewicz JJ, Gummett PA, Karim QN, Baron JH (1995) Changes in the intragastric distribution of Helicobacter pylori during treatment with omeprazole. Gut 36:12–16
Graham DY, Genta R, Evans DG, Reddy R, Clarridge JE, Olson CA, Edmonds AL, Siepman N (1996) Helicobacter pylori does not migrate from the antrum to the corpus in response to omeprazole. Am J Gastroenterol 91:2120–2124
Kalantar J, Xia HHX, Wyatt JMa, Rose D, Talley NJ (1997) Determination of optimal biopsy sites for detection of H. pylori in patients treated or not treated with antibiotics and anti-secretory drugs. Gastroenterology 112:A165
Sewell WCA (2005) Histopathology and cytopathology of limited or no clinical value, 2nd edn. Royal College of Pathologists, UK
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This work was supported by the Aga Khan University Research Grant SM 100 327*11 431 to JY. The authors are grateful to Mr. Loay Lubbad and other staff members at the Juma Research Building, Aga Khan University for their assistance during this work.
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Yakoob, J., Jafri, W., Abbas, Z. et al. The Diagnostic Yield of Various Tests for Helicobacter pylori Infection in Patients on Acid-Reducing Drugs. Dig Dis Sci 53, 95–100 (2008). https://doi.org/10.1007/s10620-007-9828-y
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DOI: https://doi.org/10.1007/s10620-007-9828-y