<p><em>Helicobacter pylori</em> And Duodenal Ulcer: Systematic Review Of Controversies In Causation</p>

Abstract

BackgroundThere are controversies on the causal role of H. pylori in duodenal ulceration. Helicobacter pylori are curved gram-negative microaerophilic bacteria found at the layer of gastric mucous or adherent to the epithelial lining of the stomach. It’s a public health significance bacteria starting from discovery, and the prevalence and severity of the infection varies considerably among populations. H. pylori are a risk for various diseases, while the extent of host response like gastric inflammation and the amount of acid secretion by parietal cells affects the outcome of infection.MethodRelevant literature were searched from databases such as Google Scholar, PubMed, Hinari, Web of Science, Scopus, and Science Direct.ResultThe review evidence supports a strong causal relation between H. pylori infection and duodenal ulcer, as patients are more likely to be infected by virulent strains which later cause duodenal ulceration. Thus, eradication of H. pylori infection decreases the incidence of duodenal ulcers, and prevents its recurrence by reducing both basal gastrin release and acid secretion without affecting parietal cell sensitivity. On the other hand, some studies show that H. pylori infection is not associated with the development of duodenal ulcers and such a lack of association revealed that duodenal ulceration has different pathogenesis.ConclusionDespite controversies observed in the causal role of H. pylori to duodenal ulceration by various studies, Hill criteria of causation proved the presence of a causal relation between H. pylori infection and duodenal ulcers. Other factors are also responsible for the development of duodenal ulcers and such factors are responsible for the differences in the prevalence of the diseases.

Vonoprazan non‐inferior to lansoprazole in treating duodenal ulcer and eradicating Helicobacter pylori in Asian patients

“…Peptic ulcer disease is more prevalent in Asian than Western populations, 6–8 and the fatality rate remains high at approximately 3–10% 1,5 . Helicobacter pylori infection is a major risk factor for gastric or duodenal ulcers, contributing to an estimated 85% of cases 1,6,9 . An epidemiologic study found that 93% of Chinese patients with peptic ulcer disease had H. pylori infection 6 .…”

“…1,5 Helicobacter pylori infection is a major risk factor for gastric or duodenal ulcers, contributing to an estimated 85% of cases. 1,6,9 An epidemiologic study found that 93% of Chinese patients with peptic ulcer disease had H. pylori infection. 6 H. pylori infection is associated with a sixfold increased risk of developing gastric cancer, 10 and H. pylori antibiotic resistance is increasing, 11 especially in Asia where clarithromycin and metronidazole resistance rates are high (> 15%).…”

Laparoscopy: A Better Approach for Perforated Duodenal Ulcer

“…The incidence of this disease is about 1 in 600 emergency presentations during usual months, but various studies published in Pakistan have observed that the incidence of PDU becomes higher during the holy month of Ramadan. Apart from the various general factors such as use of non-steroidal anti-inflammatory drugs, smoking, stress-related disorders, and Helicobacter pylori infection contributing most of the cases [9][10][11][12], certain other factors such as prolonged fasting contribute to its higher incidence in Ramadan [13]. Laparoscopy was introduced in the ED of Holy Family Hospital, Rawalpindi, Pakistan, three years back.…”

Emergency Laparoscopic Management of Perforative Peritonitis: A Retrospective Study

“…However, greater acceptance of laparoscopy in recent years has encouraged surgeons to use it due to its proven benefits of less pain, short hospital stays, faster recuperation, and decreased morbidity [ 4 - 6 ]. Performing diagnostic laparoscopy in cases of suspected viscous perforation or peritonitis has the advantage of identifying an occasionally unexpected pathology.…”