Abahussain E A, Hasan F A, Nicholls P J
Department of Medicine, Community Medicine and Behavioural Sciences, Faculty of Medicine, University of Kuwait, and Welsh School of Pharmacy, University of Cardiff, Cardiff, U.K.
Ann Saudi Med. 1998 Nov-Dec;18(6):502-5. doi: 10.5144/0256-4947.1998.502.
Dyspepsia is a very common symptom, and is the reason for most referrals for esophagogastroduodenoscopy (EGD). Peptic ulcer disease (PUD), gastroesophageal reflux and gastric cancer account for a minority of such patients. However, the majority have no significant endoscopic abnormalities (non-ulcer dyspepsia). Recently, infection with Helicobacter pylori (HP) has been implicated in the pathogenesis of PUD and gastric cancer. Since HP can be diagnosed by noninvasive techniques, it has been suggested that endoscopy should be restricted to HP-positive patients who do not respond to empirical therapy with antimicrobials. The aim of this study was to establish the prevalence of HP among Kuwaiti dyspeptic patients referred for endoscopy and to determine whether demographic and clinical screening, or the presence of HP, can help distinguish groups of patients with significant gastroduodenal pathology from those with non-ulcer dyspepsia.
Two hundred randomly selected Kuwaiti patients referred for endoscopy were evaluated prospectively. A detailed personal interview was conducted to establish the demographic and clinical profile of each patient and a diagnostic EGD was performed after the interview. Finally, antral mucosal biopsies were taken to determine the presence of HP. The pre-coded data were analyzed.
The main endoscopic findings were normal (32%), non-erosive antral gastritis (26%), duodenitis (17.5%), duodenal ulcer (11.5%), deformed bulb (4%), esophagitis (7%), and erosive gastritis (2%). The demographic and clinical characteristics of patients did not correlate with endoscopic findings. The overall prevalence of HP infection was 88.5%. There were no statistically significant differences in the prevalence of HP among patients with various endoscopic findings.
HP infection is common in Kuwaiti dyspeptic patients referred for endoscopy, irrespective of their demographic and clinical features or the underlying cause of dyspepsia. Noninvasive methods to detect HP are not valid alternatives to endoscopy in the work-up of dyspeptic patients.
消化不良是一种非常常见的症状，是大多数食管胃十二指肠镜检查（EGD）转诊的原因。消化性溃疡病（PUD）、胃食管反流和胃癌占此类患者的少数。然而，大多数患者没有明显的内镜异常（非溃疡性消化不良）。最近，幽门螺杆菌（HP）感染被认为与PUD和胃癌的发病机制有关。由于HP可以通过非侵入性技术诊断，有人建议内镜检查应仅限于对经验性抗菌治疗无反应的HP阳性患者。本研究的目的是确定科威特因消化不良而转诊进行内镜检查的患者中HP的患病率，并确定人口统计学和临床筛查或HP的存在是否有助于区分有明显胃十二指肠病变的患者群体和非溃疡性消化不良患者群体。
前瞻性评估了200名随机选择的科威特转诊进行内镜检查的患者。进行了详细的个人访谈以确定每位患者的人口统计学和临床特征，并在访谈后进行了诊断性EGD。最后，采集胃窦黏膜活检样本以确定HP的存在。对预先编码的数据进行了分析。
主要内镜检查结果为正常（32%）、非糜烂性胃窦炎（26%）、十二指肠炎（17.5%）、十二指肠溃疡（11.5%）、球部变形（4%）、食管炎（7%）和糜烂性胃炎（2%）。患者的人口统计学和临床特征与内镜检查结果无关。HP感染的总体患病率为88.5%。不同内镜检查结果的患者中HP患病率无统计学显著差异。
在科威特因消化不良而转诊进行内镜检查的患者中，HP感染很常见，无论其人口统计学和临床特征或消化不良的潜在原因如何。在消化不良患者的检查中，检测HP的非侵入性方法不能有效替代内镜检查。
