Helicobacter pylori infection and gastric function in patients with chronic idiopathic dyspepsia

Tucci, Antonio; Corinaldesi, Roberto; Stanghellini, Vincenzo; Tosetti, Cesare; Febo, Giulio Di; Paparo, G. F.; Varoli, O; Paganelli, Gian Maria; Labate, Antonio Maria Morselli; Masci, C.; Zoccoli, G.; Monetti, Nino; Leggett, Barbara A.

doi:10.1016/0016-5085(92)90004-i

Cited by 194 publications

(94 citation statements)

References 32 publications

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“…Studies have reported inconsistent results regarding the levels of gastric acid secretion in patients with functional dyspepsia. 6,10,11 Actually, evidence that gastric hyperchlorhydria is one of the major pathophysiologic mechanisms of functional dyspepsia is lacking. Moreover, atrophic gastritis is common in the general population of South Korea and Japan where H. pylori is highly prevalent.…”

Section: Discussionmentioning

confidence: 99%

“…[4][5][6][7][8][9] However, previous reports regarding the levels of gastric acid secretion in dyspeptic patients showed controversial results. 6,10,11 Furthermore, atrophic gastritis is common in the general population of South Korea and Japan where Helicobacter pylori infection is highly prevalent. The extent or grade of atrophic gastritis may influence on the level of gastric acid secretion.…”

Section: Introductionmentioning

confidence: 99%

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Association of the Extent of Atrophic Gastritis With Specific Dyspeptic Symptoms

Chung

Lee

Kim

et al. 2015

J Neurogastroenterol Motil

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Background/AimsIt remains unclear whether atrophic gastritis can affect dyspeptic symptoms. We aimed to investigate whether the extent of atrophic gastritis is associated with specific dyspeptic symptoms. MethodsConsecutive adults in a routine health-checkup program were enrolled in the study. The extent of atrophic gastritis was classified into 3 groups based on the Kimura-Takemoto criteria; the gastritis with no or little atrophy (group A: C0), the gastritis with atrophy mainly in the antrum (group B: C1 and C2), and the gastritis with atrophy in the large area of the corpus (group C: C3 and O). Upper gastrointestinal symptoms were categorized into "typical reflux symptoms," "epigastric pain syndrome (EPS)-related symptoms," and "postprandial distress syndrome (PDS)-related symptoms." ResultsA total of 1827 patients (1009 males, mean age 45.1 years) were included in the analysis. The subgroups of atrophic gastritis were as follows: group A (n = 1218, 66.7%), group B (n = 392, 21.4%), and group C (n = 217, 11.9%). Typical reflux, EPS-related, and PDS-related symptoms were present in 10.5%, 19.8%, and 16.2% of the subjects, respectively. PDS-related and EPS-related symptoms were significantly more prevalent in the group C of male patients and the group B of female patients, respectively, compared with other groups. PDS-related and EPS-related symptoms were independently associated with the group C in males (OR, 2.123; 95% CI, 1.090-4.136) and the group B in females (OR, 2.571; 95% CI, 1.319-5.025), respectively. ConclusionsThe extent of atrophic gastritis appears to affect the generation of specific dyspeptic symptoms in a gender-dependent manner. (J Neurogastroenterol Motil 2015;21:528-536)

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Association of the Extent of Atrophic Gastritis With Specific Dyspeptic Symptoms

Chung

Lee

Kim

et al. 2015

J Neurogastroenterol Motil

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“…ULD patients had significantly higher H. pylori colonisation of the gastric mucosa than did patients with endoscopic oesophagitis, DLD, undefined symptomatology or no symptoms at all. A relationship between ulcer-like epigastric pain and H. pylori infection has been reported in some, though not all studies [15,18,42,43], and confirmed by symptom remission in some patients in whom H. pylori infection was eradicated [9,16].…”

Section: Discussionmentioning

confidence: 99%

“…Early reports on the coexistence of gastritis in patients with reflux oesophagitis or reflux symptoms may suggest gastritis, especially of the cardias, as one such factor [7][8][9]. On the other hand, the demonstration of a close relationship between Helicobacter pylori gastritis and peptic ulcer [10][11][12][13] suggested a similar correlation between H. pylori gastritis and non-ulcer dyspepsia, especially with ulcer-like symptoms [9,[14][15][16], despite controversial findings [17,18] and considerable criticism [19].…”

Section: Introductionmentioning

confidence: 99%

Analysis of Gastroduodenitis and Oesophagitis in Relation to Dyspeptic/Reflux Symptoms

Villani¹,

Trespi²,

Fiocca³

et al. 1998

Digestion

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Background/Aims: The pathogenesis of dyspeptic/reflux symptoms and the clinico-pathologic profile of affected patients are still poorly understood. To improve our knowledge in this field we carried out a systematic, comparative analysis of symptom profiles and histopathologic patterns of oesophagogastroduodenal mucosa in a series of 221 subjects, 140 with and 81 without endoscopic evidence of hiatal hernia. Of these, 190 showed reflux and/or dyspeptic symptoms. Methods: Before endoscopy, all the subjects were questioned about the presence and severity of 12 individual symptoms. Biopsies were taken from the distal oesophagus, cardia, corpus, angulus, antrum and duodenal bulb, and were scored in accordance with the Sydney system. Results: Patient groups with a distinct clinico-pathologic profile were better identified when symptoms of adequate severity were compared with histopathologic parameters. A correlation between gastroesophageal reflux disease (GORD) symptoms and histologic signs of oesophagitis was mostly restricted to patients endoscopically positive for oesophagitis. Retroxiphoid pyrosis correlated with cardial gastritis but not with oesophagitis, either endoscopic or histologic, while ulcer-like epigastric pain correlated with active duodenitis and distal gastritis. No definite histopathologic background was detected in patients with putative dysmotility-like symptoms, endoscopy-negative GORD and low score or mixed symptoms. Conclusion: A contribution of Helicobacter pylori gastroduodenitis to the pathogenesis of some dyspeptic symptoms seems likely. However, the identification of specific histologic changes causing individual symptoms remains rather elusive, with the exception of active antroduodenitis in patients with ulcer-like pain and of active proximal gastritis in patients with severe retroxiphoid pyrosis.

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“…In the present study patients with such disorders were excluded and the finding of equally delayed gastric emptying in both genders would support that eating disorders were not present. We did not routinely test for H pylori in this study, but there is no evidence that Hp infection has any relationship with symptoms and delayed gastric emptying in functional dyspepsia [45][46][47][48][49] . Thus, it seems unlikely that knowledge of the Hp status would have altered the conclusions of the present study.…”

Section: Discussion Discussion Discussion Discussion Discussionmentioning

confidence: 96%

Relationship between gastrointestinal and extra-gastrointestinal symptoms and delayed gastric emptying in functional dyspeptic patients

Pallotta

Pezzotti²,

Calabrese³

et al. 2005

WJG

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Abstract Abstract Abstract AIM: Delayed gastric emptying and an enlarged fasting gastric antrum are common findings in functional dyspepsia but their relationship with gastrointestinal (GI), and the frequently associated extra-GI symptoms remains unclear. This study evaluated the relationship between GI and extra-GI symptoms, fasting antral volume and delayed gastric emptying in functional dyspepsia. METHODS:In 108 functional dyspeptic patients antral volume and gastric emptying were assessed with ultrasonography (US). Symptoms were assessed with standardized questionnaire. The association of symptoms and fasting antral volume with delayed gastric emptying was estimated with logistic regression analysis. RESULTS:Delayed gastric emptying was detected in 39.8% of the patients. Postprandial drowsiness (AOR 11.25; 95%CI 2.75-45.93), nausea (AOR 3.51; 95%CI 1.19-10.32), fasting antral volume (AOR 1.93; 95%CI 1.22-3.05), were significantly associated with delayed gastric emptying. Symptoms, mainly the extra-GI ones as postprandial drowsiness and nausea, combined with fasting antral volume predicted the modality of gastric emptying with a sensitivity and specificity of 78%. CONCLUSION:In functional dyspeptic patients, (1) an analysis of fasting antral volume and of symptoms can offer valuable indication on the modality of gastric emptying, and (2) it seems appropriate to inquire on postprandial drowsiness that showed the best correlation with delayed gastric emptying.

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Helicobacter pylori infection and gastric function in patients with chronic idiopathic dyspepsia

Cited by 194 publications

References 32 publications

Association of the Extent of Atrophic Gastritis With Specific Dyspeptic Symptoms

Association of the Extent of Atrophic Gastritis With Specific Dyspeptic Symptoms

Analysis of Gastroduodenitis and Oesophagitis in Relation to Dyspeptic/Reflux Symptoms

Relationship between gastrointestinal and extra-gastrointestinal symptoms and delayed gastric emptying in functional dyspeptic patients

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