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Title

Helicobacter Pylori Colonization Density is an Important Risk Factor for Eradication Therapy.

Authors

Demirci, Hakan; Ozturk, Kadir; Tanoglu, Alpaslan; Kilciler, Ayse Guldem; Gunal, Armagan; Gulsen, Mustafa; Uygun, Ahmet

Abstract

Background & Aims: Despite the known risk factors, it is not clear why the same treatment protocol for Helicobacter pylori infection (H. pylori) does not show a similar effect in patients with common risk factors. We hypothesized that as the severity of H. pylori - induced gastric mucosa inflammation and density increase, the rate of successful treatment decreases. This study aimed to explore the existence of a possible association between gastric H. pylori colonization density and the efficacy of bismuth-containing quadruple eradication therapy. Methods: A total of 330 patients with H. pylori positive gastritis were initially included; the diagnosis was based on the histopathological examination. H. pylori colonization density was graded according to the Sydney classification: mild (n=101), moderate (104) and severe (98). H. pylori eradication was determined via the 13C-Urea breath test performed eight weeks after therapy. Results: There was no significant difference in terms of the distributions of age, gender, alcohol consumption, and smoking status among the groups (p>0.05). The successful eradication rates of H. pylori were 87.1%, 78.8%, and 75.5%, respectively, for the mild, moderate, and severe H. pylori colonization groups by per-protocol analysis (p=0.038). The eradication rates of H. pylori were 81.5%, 73.2%, and 67.3% respectively, for the mild, moderate, and severe H. pylori colonization groups by intention-to-treat analysis (p=0.017). Conclusions: Helicobacter pylori colonization severity might predict the usefulness of eradication therapy in pre-treatment assessment. We recommend the use of more effective therapy regimens for H. pylori eradication in patients with severe densities.

Subjects

SYDNEY (N.S.W.); HELICOBACTER pylori infections; BACTERIAL colonies; HELICOBACTER pylori; DISEASE risk factors; GASTRIC mucosa; DENSITY

Publication

Journal of Gastrointestinal & Liver Diseases, 2022, Vol 31, Issue 2, p163

ISSN

1841-8724

Publication type

Academic Journal

DOI

10.15403/jgld-4238

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