NEW SES OF HELICOBACTER-PYLORI-ASSOCIATED DUODENAL-ULCER

Aim. Generalization of the results obtained through analysis of examin ations of new cases of duoclenal ulcer (DU) with patients suffering fr om DU of different duration, made in two main aspects: the patients' H elicobacter pylori (HP) status determined by histological, bacteriolog ical, immunological studies and rapid urease test and their clinical m anifestations, including analysis of risk factors predisposing to pept ic ulcer. Materials and Methods. Two groups of patients with DU: 1) 23 new cases; 2) (a group of comparison) 43 patients with DU of differen t duration were examined. Family history, risk factors (smoking, alcoh ol consumption, use of nonsteroidal antiinflammatory agents), concurre nt diseases were analyzed. Esophagogastroduodenoscopy (EGDS), ph metry , histological, bacteriological studies, rapid urease test and IgG ant iHP determination were made. Results. More than 95% of patients with D U were found to have HP just at the moment of diagnosis. New cases of DU have less HP colonization in the mucosa. The best diagnostic result s were obtained with a combination of a histological study and a rapid urease test. 74% of new DU cases have scarring-ulcerative deformity o f the duodenal bulk and, therefore, the onset of peptic ulcer was asym ptomatic or mild. DU accompanied by hemorrhage averaged 4.5%;. A third of new cases have simultaneously 2 ulcer defects in the duodenal bulb . The pains and symptoms of gastric dyspepsia are typical of the two g roups of patients; however, of particular significance for their forma tion are functional disorders in new cases and organic changes in othe r patients. Conclusion. The comparison of the diagnostic techniques fo r HP allows the authors to recommend a combination of a histological s tudy and a rapid urease test as the most informative tool.