Clinical, Endoscopic, Pathological and Serological Findings of Helicobacter pylori Infection in Saudi Patients with Upper Gastrointestinal Diseases

Abstract

Background: The prevalence of Helicobacter pylori is typically higher in developing countries like Saudi Arabia. Aims: To estimate the prevalence of H. pylori among patients suffering from upper gastrointestinal (GI) symptoms, know the main risk factors leading to infection, and detect the clinical, endoscopic and pathological changes of the gastric mucosa of patients infected with H. pylori. Place and Duration of Study: This is a five-months prospective study conducted in King Fahd Hospital, Al-Madinah, Saudi Arabia. Methodology: H. pylori status in patients was determined by two biopsy based tests (histology and rapid urease test) as invasive tests and by a serological testing (ELISA IgG) as non-invasive test. Results: The age of the selected 68 patients ranged from 18-70 years with a mean age of 37.9 ± 14.15 years. H. pylori was more prevalent among males than females (70.5% vs 29.5%, p=0.020) and among age group (18-< 30) years. No significant difference was estimated between positive and negative HP cases in residency, work status, marital status, smoking, socioeconomic level and aspirin intake. The most common complaints in the selected patients having endoscopy were: epigastric pain, heart burn, and dyspepsia. A significant correlation was detected between H. pylori and each of age, sex and Diabetes Mellitus. The most prevalent endoscopic findings of the positive H. pylori cases were mild gastritis (84.1%). There was a significant difference in gastritis (p=0.003) and duodenitis (p=0.031) between positive and negative cases for H. pylori histopathology. The prevalence of H. pylori was 60.29% by rapid urease test, 64.7% by histopathological examination and 67.6% by serology among the studied cases. Conclusion: H. pylori-infected patients with upper GI symptoms were found to have more abnormal endoscopic and pathological findings than those without H. pylori infection.