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Query: UMLS:C0013395 (dyspepsia)
 4,879 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The purpose of the communication is to review the different aspects of the Helicobacter (Campylobacter) pylori infection. The first part of the communication is devoted to the description of the different gastric pathologies induced by the Helicobacter pylori infection and to the different methods used for the detection of this infection. Today a consensus assesses a causal role to Helicobacter pylori in the development of chronic active gastritis (or type B gastritis), in the pathogenesis of duodenal ulcer, and a major contributing factor in the development of peptic ulcer disease. The possible role played by this bacterium in the development of non-ulcer dyspepsia is still unclear. H. pylori infections can be detected using different methods including invasive methods--requiring an endoscopy (e.g.: culture of the micro-organism, urease test, microscopy) and non-invasive methods (e.g.: breath test, serology). Each of these methods has advantages but also some disadvantages, and none shows an absolute sensitivity and specificity. The second part of the presentation analyses the results obtained with a serologic method using a specific fractioned and purified antigenic complex extracted from Helicobacter pylori. This report demonstrates a good correlation with the other detection methods. Serology appears also as a useful tool for the therapeutical monitoring of infected patients. Serological results must however be interpreted in the light of the complete clinical examination of the patient.
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PMID:[The role of serology in the diagnosis of Helicobacter (Campylobacter) pylori infection]. 180 38

We studied 102 workers in a mechanical factory. All subjects were tested by a questionnaire screening dyspeptic symptoms in the last three months, their frequency, absenteeism period, spontaneous drugs intake and a consultant gastroenterologist request. All subjects were tested for specific IgG against Helicobacter pylori with immunoassay Elisa. Dyspepsia was present in 61% of cases. Positivity for Helicobacter pylori infection was in 76%, absenteeism in 82%, consultant request in 21% of dyspeptic workers. Our results suggest, according to literature, the high frequency of Helicobacter pylori infection in dyspeptic patients: furthermore dyspepsia should be considered as an important cause of absenteeism.
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PMID:[Dyspepsia and Helicobacter pylori infection. A study of a population of workers]. 184 64

The role of Helicobacter pylori infection in the symptom complex associated with non-ulcer dyspepsia is uncertain, despite the presence of the organism in a high proportion of these patients. In order to exclude physician bias in history taking, 18 patients (9 female) diagnosed as non-ulcer dyspepsia, after endoscopy and gallbladder ultrasonography, underwent computer interrogation using the Glasgow Diagnostic System for Dyspepsia (GLADYS). Five antral and 3 fundal endoscopic biopsies from these patients were also histologically examined for the presence of Helicobacter pylori and quantitatively analysed for polymorph and chronic inflammatory cell densities per mm2 of lamina propria using computer-linked image analysis. In the group of 9/18 patients who were positive for Helicobacter pylori, there were significantly higher antral and fundal inflammatory cell counts than in negative patients. However, analysis of the GLADYS interrogation data showed no significant positive relationships between Helicobacter pylori positivity and any gastrointestinal symptoms. These results confirm a significant association between Helicobacter pylori and superficial gastritis but suggest that non-ulcer dyspepsia in patients with Helicobacter pylori colonisation is probably not a clinically identifiable and distinct syndrome.
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PMID:A comparison of symptoms between non-ulcer dyspepsia patients positive and negative for Helicobacter pylori. 185 92

The role of Helicobacter pylori infection in causing chronic dyspepsia is in need of further clarification. More well-designed prospective studies are necessary to ascertain whether and to what extent H. pylori-related chronic inflammation in the stomach and the duodenum causes dyspeptic symptoms; whether and to what extent there is a symptom cluster characteristic for H. pylori-related gastroduodenitis; whether and to what extent H. pylori infection is demonstrable in the chronic dyspeptic population; and whether and to what extent H. pylori infection interferes with gastrin homoeostasis and acid secretion or induces motor disturbances. Well-designed prospective H. pylori-eradication studies may further contribute in unravelling its role in chronic dyspepsia, especially in patients with active polymorphonuclear gastroduodenitis and hyperacidity.
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PMID:Is gastroduodenitis a cause of chronic dyspepsia? 189 28

The relationship between endoscopically diagnosed gastroduodenitis, histologically confirmed gastritis, and symptoms of dyspepsia remains unclear. Marked histologically confirmed inflammation of gastric mucosa often occurs in a stomach that appears normal by endoscopy. Both histologically confirmed and endoscopically diagnosed gastritis are commonly blamed as causes of nonulcer dyspepsia (NUD), although neither disease has been convincingly shown to cause NUD. Helicobacter pylori infection of gastric mucosa is a common cause of histologically confirmed inflammation. It is unclear whether this infection with H. pylori and the resultant gastric mucosal inflammation cause symptoms since inflamed mucosae are also common in asymptomatic controls. The reported increased prevalence of H. pylori in patients with NUD compared with controls suggests a possible causative role in at least a subset of patients with NUD. In addition, three controlled studies of treatment with bismuth demonstrated a significant trend toward improvement of symptoms after clearance of H. pylori. However, two studies of therapy with bismuth failed to demonstrate improvement of symptoms. Further study of patients with NUD is needed to clarify this possible association.
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PMID:Helicobacter pylori in patients with nonulcer dyspepsia. 192 11

A retrospective study was performed on gastric carcinomas to establish the prevalence of Helicobacter pylori infection in gastric epithelium adjacent to the tumour. A total of 105 carcinomas were studied. The overall prevalence of Helicobacter pylori infection was 59%. The prevalence in different age cohorts from patients with gastric carcinoma was compared with that in patients suffering from non-ulcer dyspepsia and, based on serological testing, with that in healthy blood donors. The presence of Helicobacter pylori in cancer patients aged 41-50 and 51-60 was significantly higher than in blood donors. No difference was seen in comparison with non-ulcer dyspepsia patients. The presence of Helicobacter pylori showed an inverse correlation with the extent of intestinal metaplasia. The intestinal type of carcinoma was associated with a higher bacterial load than the diffuse type. These data suggest that the presence of Helicobacter pylori in gastric mucosa could play a role in the pathogenesis of gastric carcinoma, especially in the young age group.
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PMID:Helicobacter pylori and gastric carcinoma. 179 61

There is evidence that Helicobacter pylori infection is associated with gastric cancer and mucosa-associated lymphoid tissue (MALT) lymphoma and possibly with non-ulcer dyspepsia. Eradication therapy for confirmed H. pylori infection may therefore become mandatory in patients with non-ulcer dyspepsia severe enough to warrant endoscopy and in first-degree relatives of patients with gastric cancer. However, routine treatment of asymptomatic carriers awaits confirmation of the association with cancer.
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PMID:Helicobacter pylori and gastric neoplasia: evolving concepts. 756 11

Patients with recurrent upper abdominal complaints and without peptic ulcer or definite evidence of organic disease have been labelled as suffering from nonulcer dyspepsia and included in the study. A total of 125 patients were studied and upper gastrointestinal endoscopy performed. Histology, urease rapid test and ELISA serology were done in order to detect Helicobacter pylori infection. Age groups were done. The most frequent endoscopic and histological finding was chronic gastritis in all age groups of patients. In patients under 30 years old, the highest rate of normal endoscopy was found. Chronic gastritis was associated with Helicobacter pylori infection in 89.8% of all patients. The highest rate of chronic gastritis non associated with Helicobacter pylori infection was found in the age group of patients younger than 30 years old. Other factors as biliary reflux, gastroduodenal dismotility, decreased pain tolerance or stress have been proposed to be the etiology of chronic gastritis in young patients.
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PMID:[Chronic gastritis and Helicobacter pylori in patients with non-ulcerous dyspepsia. Role and significance of age]. 757 11

The objective of this study was to conduct a survey of the opinions and practices of gastroenterologists in the United Kingdom concerning the impact of Helicobacter pylori infection on the management of upper gastrointestinal diseases. A postal questionnaire was sent to all medically qualified members of the British Society of Gastroenterology working in the UK. Replies were received from 670 of 1037 eligible BSG members (65%). Of these, 73% thought that H pylori was a cause of duodenal ulcer and 84% thought that eradication of H pylori decreased ulcer recurrence in comparison with acid suppression. While 80% used anti-H pylori therapy for a chronic relapsing duodenal ulcer, only 25% used such therapy for an ulcer at first presentation and 17% never used anti-H pylori therapy for patients with duodenal ulcer. Although 75% of respondents did not agree that H pylori was a cause of non-ulcer dyspepsia, 69% used anti-H pylori therapy to treat a patient with this condition. At the time of the survey, 69% of those who used anti-H pylori therapy adopted some variant of standard triple therapy. Only 7% routinely tested for bacterial sensitivity to antibiotics and only 22% assessed their patients for eradication after treatment. There was a lack of consensus about whether H pylori was a cause of gastric ulcer or gastric cancer with only 47% and 17% respectively believing in these associations. In conclusion, at the time of the survey, the use of anti-H pylori therapy had been accepted by a majority of specialist UK gastroenterologists in the management of upper gastrointestinal disease. There was, however, a substantial degree of uncertainty and divergence about which patients should be treated.
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PMID:Helicobacter pylori and upper gastrointestinal disease: a survey of gastroenterologists in the United Kingdom. 759 Apr 23

In patients who present with chronic unexplained upper abdominal pain or discomfort (functional dyspepsia), therapy should ideally be targeted on correcting the individual's disturbed pathophysiology. Here, putative mechanisms implicated in functional dyspepsia and potential approaches to therapy are critically reviewed in order to determine if targeting treatment is of value. Pharmacological therapies reviewed include those that aim to correct disordered gastric emptying (e.g. cisapride, dopaminergic receptor antagonists, macrolides), reduce visceral hypersensitivity (e.g. somatostatin analogues, cholecystokinin antagonists, opioid agonists, serotonin type 3 receptor antagonists), reduce gastric acid secretion (e.g. H2-blockers, acid pump inhibitors), cure Helicobacter pylori infection, enhance muscosal defence (e.g. sucralfate, bismuth) or modify central nervous system processes. It is concluded that the imperfectly understood pathophysiology of functional dyspepsia contributes to the paucity of established efficacious therapies.
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PMID:Review article: functional dyspepsia--should treatment be targeted on disturbed physiology? 760 50


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