High prevalence of duodenal ulcer in a tertiary care hospital in the city of São Paulo, SP, Brazil

-Background -Peptic ulcer etiology has been changing because of H. pylori decline. Objective -To estimate peptic ulcer prevalence in 10 years-interval and compare the association with H. pylori and use of non-steroidal anti-inflammatory drugs. Non-steroidal anti-inflammatory drugs use was 3.5% in A and 13.3% in B. Neither condition occurred in 10.4% and 20.5% in A and B respectively. Comparing both periods, we observed reduction of peptic ulcer associated to H. pylori (P=0.000), increase of peptic ulcer related to non-steroidal anti-inflammatory drugs (P=0.000) and idiopathic peptic ulcer (P=0.002). The concurrent association of H. pylori and non-steroidal anti-inflammatory drugs was also higher in B (P=0.002). Rates of gastric ulcer were higher and duodenal ulcer lower in the second period. Conclusions -After 10 years, the prevalence of peptic ulcer decreased, as well as ulcers related to H. pylori whereas ulcers associated to non-steroidal anti-inflammatory drugs increased.There was an inversion in the pattern of gastric and duodenal ulcer and a rise of idiopathic peptic ulcer. HEADINGS -Peptic ulcer. Helicobacter pylori. Non-steroidal anti-inflammatory agents. Stomach ulcer. Duodenal ulcer.

Section: Introductionmentioning

confidence: 99%

Peptic Ulcer Frequency Differences Related to H. Pylori or Aines

Carli

Pires

Rohde

et al. 2015

“…There is no reported difference between sexes (50,58) . Studies in different countries reveal prevalence of infection between 11% and 69% in the general population (7) and between 8.9% and 72.8% in children, respectively in developed and developing countries (42) . Along recent years a reduction of the infection rates was observed, most evident in occidental industrialized countries and in some oriental emergent economies (5,6,7) .…”

Section: Resultsmentioning

confidence: 99%

“…A report on patients in the southern states revealed low prevalence of duodenal peptic ulcer (54) . Marques et al (42) studied 1478 consecutive higher digestive organ endoscopic examinations realized in a tertiary care hospital in the city of São Paulo, finding peptic ulcers in 494 (33.4%). Infection with H. pylori was diagnosed in 252 (64%) patients with duodenal ulcer, 59 (57%) of bearers of gastric ulcer and 143 (53%) patients with normal endoscopy.…”

Section: Resultsmentioning

confidence: 99%

“…The only exceptions to this rule were the epidemiologic studies of the infection that employed other tests (e.g., urease test on biopsies, 13 C-urea breath test, seroprevalence of antibodies, culture and stool antigen test). Patients were classified as having H. pylori-negative ulcer if no test was positive and at least two tests were negative; an exception was a Brazilian study of PUD (42) , included due to the scarcity of studies in the country.…”

Section: Methodsmentioning

confidence: 99%

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ETIOPATHOGENESIS OF PEPTIC ULCER: back to the past?

Araujo

Borini

Guimarães

2014

-Objective -To review some aspects of the etiopathogenesis of peptic ulcerous disease especially on the basis of studies on its correlation with Helicobacter pylori (H. pylori). Methods -A search was made in the data bases MEDLINE, LILACS and PubMed, and in Brazilian and foreign books, referring to the incidence and prevalence of infection by H. pylori and of peptic ulcerous disease in various populations of different countries. Results -It was observed that the prevalence of H. pylori infection is similar in individuals with peptic ulcerous disease and the general population. There are differences between countries with respect to the prevalence of infection and of gastric or duodenal peptic ulcers. In many countries the prevalence of infection by H. pylori shows stability while the prevalence of peptic ulcerous disease is declining. The prevalence of peptic ulcerous disease without H. pylori infection varies between 20% and 56% in occidental countries. Discussion -The observations might be suggestive of H. pylori being only one more factor to be summed together with other aggressive components in the genesis of peptic ulcerous disease. We would therewith be returning to the classic concept that peptic gastric and duodenal ulcers have multifactorial etiology and would result from imbalance between aggressive and defensive factors. The focus of studies should be enriched with the identification of the defensive factors and of other aggressive factors besides the well known H. pylori and non-steroidal anti-inflammatory drugs, since these two aggressors do not exhaust the full causal spectrum. HEADINGS -Peptic ulcer. Stomach Ulcer. Duodenal ulcer. Helicobacter infections.

“…The sample size of 42 patients was calculated through a test between a null hypothesis given by Kappa statistic equal to 0.4 (fair) and an alternative hypothesis with Kappa statistic equal to 0.8 (substantial) for a prevalence of 53% of H. pylori in the studied population (18) , considering a statistical significance of 5% and a power of 80%.…”

Section: Statistical Analysesmentioning

confidence: 99%

Low Dose Capsule Based 13c-Urea Breath Test Compared With the Conventional 13c-Urea Breath Test and Invasive Tests

Mattar

Villares

Marostegam

et al. 2014

Self Cite

-Context-One of the limitations of 13 C-urea breath test for Helicobacter pylori infection diagnosis in Brazil is the substrate acquisition in capsule presentation. Objectives-The purpose of this study was to evaluate a capsule-based 13 C-urea, manipulated by the Pharmacy Division, for the clinical practice. Methods-Fifty patients underwent the conventional and the capsule breath test. Samples were collected at the baseline and after 10, 20 and 30 minutes of 13 C-urea ingestion. Urease and histology were used as gold standard in 83 patients. Results-In a total of 50 patients, 17 were positive with the conventional 13 C-urea (75 mg) breath test at 10, 20 and 30 minutes. When these patients repeated breath test with capsule (50 mg), 17 were positive at 20 minutes and 15 at 10 and 30 minutes. The relative sensitivity of 13 C-urea with capsule was 100% at 20 minutes and 88.24% at 10 and at 30 minutes. The relative specificity was 100% at all time intervals. Among 83 patients that underwent capsule breath test and endoscopy the capsule breath test presented 100% of sensitivity and specificity. Conclusion-Capsule based breath test with 50 mg 13 C-urea at twenty minutes was found highly sensitive and specific for the clinical setting. HEADINGS-Helicobacter pylori. Breath Test. Urea, analysis.