THE SPECTRUM OF HELICOBACTER-PYLORI IN UPPER GASTROINTESTINAL-DISEASE

Helicobacter pylori has been recognized as a contributing factor in ga strointestinal disease. Yet, questions remain as to its clinical signi ficance. This prospective study was done to determine the prevalence, distribution, clinical significance, and treatment response of N. pylo ri gastrointestinal infection. A total of 91 patients with upper gastr ointestinal symptoms underwent 122 esophagogastroduodenoscopies (EGD). Biopsies were taken for H. pylori from the gastric fundus, body, antr um, prepylorus, and duodenal bulb; 45.3 per cent of patients with abdo minal pain, 27.8 per cent with ''heartburn,'' and 55.6 per cent with a nemia/GI bleed had H. pylori infections. Pertaining to EGD findings: 5 4.2 per cent of patients with gastroduodenal ulcer, 56.4 per cent with gastritis/duodenitis, 37.5 per cent with esophagitis/esophageal ulcer , but only 17.6 per cent with normal findings had H. pylori infection. The distribution of H. pylori: fundus (53.3%); body (55.6%); antrum ( 85.4%); prepylorus (78.4%); duodenum (15.6%). Treatment for H. pylori was amoxicillin, metronidazole, colloid bismuth with an antisecretory drug. H. pylori was eradicated in 78.9 per cent of patients; 93.3 per cent of these patients had symptomatic improvement and/or ulcer healin g. Using stepwise logistic regression,H. pylori eradication was an ind ependent predictor of symptomatic improvement.