EFFICACY OF HYBRID THERAPY (RA-RACM) IN PATIENTS WITH HELICOBACTER PYLORI POSITIVE-CHRONIC GASTRITIS

2015 ◽  
pp. 17-23
Author(s):  
Thanh Van Nguyen ◽  
Van Huy Tran
Keyword(s):  
Adverse Effects ◽  
Atrophic Gastritis ◽  
Intestinal Metaplasia ◽  
Chronic Gastritis ◽  
Eradication Rate ◽  
Clinical Symptoms ◽  
Epigastric Pain ◽  
Upper Gastrointestinal Endoscopy ◽  
Hybrid Therapy ◽  
Hybrid Regime

Objectives: To evaluate the efficacy and adverse effects of hybrid regime in patients with chronic gastritis patients H.pylori positive. Subjects and methods: A prospective cross-sectional study was conducted on 189 chronic gastritis patients at Cho Ray Hospital, from 25/09/2013 to 29/07/2014. All patients underwent upper gastrointestinal endoscopy and biopsy to perform CLO Test and analyse histo-pathological. 92 patients H.pylori with CLO test positive were enrolled in the therapy with hybrid therapy RA-RACM. Results: 92 patients with positive H.pylori (36 males and 56 females), the mean age of population study was 41.65 ± 11.69. The percentage of H.pylori infection was 48.7. The eradication rate of H.pylori was 88.0%. In general, comparison of before and after eradication, the prevalence of epigastric pain was 89.1% vs. 69.1%, delayed gastric empty and sour reflux and the other clinical symptoms were 61.9% vs. 30.8%, 46.7% vs. 30.8% and 31.5% vs. 4.9%, respectively (p < 0.05). Endoscopically, after H.pylori eradication: congestive antritis (from 53.2% to 63.1%), raised erosion (from 15.2% to 14.1%), flat erosion (from 31.5% to 22.8%) (p > 0.05). Histopathology, before H.pylori eradication: Antral active gastritis (61.9%), atrophic gastritis (13.0%), intestinal metaplasia (6.5%), dysplasia (5.4%). Corpus active gastritis (59.8%), atrophic gastritis (5.4%), intestinal metaplasia (2.2%), dysplasia (4.3%); (p> 0.05). Most of lesions were mild. The rate of H.pylori infection in antrum (33.9%), and in corpus (28.0%). The most common adverse effects were 70.6%, mainly bitter taste, none of patients was excluded. Conclusions: The eradication rate of hybrid regime (RA-RACM) is high; the side effects were rare and relatively mild. Hybrid therapy may be considered as a first line of H.pylori treatment in current clinical practice. Key words: Chronic gastritis, hybrid regime (RA-RACM), H.pylori

CLINICAL, ENDOSCOPIC AND PATHOLOGICAL RESPONSES AFTER ERADICATION WITH RACM REGIMEN IN PATIENTS OF HELICOBACTER PYLORI-RELATED CHRONIC GASTRITIS

2016 ◽  
pp. 12-19
Author(s):  
Thi Hoai Thai ◽  
Van Huy Tran
Keyword(s):  
Helicobacter Pylori ◽  
Intestinal Metaplasia ◽  
Chronic Gastritis ◽  
Clinical Symptoms ◽  
Epigastric Pain ◽  
Bile Reflux ◽  
Helicobacter Pylori Eradication ◽  
Significant Change ◽  
H Pylori ◽  
Active Inflammation

Background: The clinical, endoscopic and histopathological responses after Helicobacter pylori eradication in patients of chronic gastritis were still inconstant. This study is aimed at: (1) evaluating of clinical variations, endoscopic images six months after Helicobacter pylori eradication by Rabeprazole-Amoxicillin—Metronidazole-Clarithromycin therapy for 14 days. (2) assessing histopathological response six months after H. pylori eradication. Method: prospective, consisting of 83 patients examined and treated in Danang hospital from 4/2014 to 6/2015. Results: There were improvements in clinical symptoms 6 months after H. pylori eradication: epigastric pain 85.5% vs. 7.2%); bloating (97.1% vs. 4.3%); indigestion (47.8% vs. 2.9%); weight loss (17.4% vs. 1.4%); anorexia (23.2% vs. 2.9%) (p< 0.01). However, there were no improvement regarding common lesions on endoscopy, edema (33.3% increase to 71%); flat erosion and elevated erosion (15.9% vs. 8.7%); atrophy (7.2%); haemorrhagic (5.8% vs. 0%); hypertrophic (7.2% vs. 0%); bile reflux (14.5% vs. 4.3%). Regarding histopathology: active inflammation accounted for a high proportion (63.8% vs. 27.5%); non-active inflammation (36.2% increase to 72.5%); atrophy (8.7% vs. 5.8%); dysplasia (26.1% vs. 1.4%), no significant change in intestinal metaplasia was found after treatment. Conclusions: There was an improvement in clinical symptoms and histopathological against inflammatory activity grade, dysplasia at the time before and after 6 months treatment H. pylori eradication. However, no significant change in mucosal atrophy and intestinal metaplasia was found. Key words: chronic gastritis; H. pylori; clinical, endoscopic and pathological responses

EFFICACY OF MODIFIED BISMUTH QUADRUPLE THERAPY (RBMA) AS FIRST-LINE THERAPY FOR ERADICATION OF HELICOBACTER PYLORI IN PATIENTS WITH CHRONIC GASTRITIS

2019 ◽  
pp. 28-32
Author(s):  
Van Huy Tran
Keyword(s):  
Helicobacter Pylori ◽  
Adverse Effects ◽  
Chronic Gastritis ◽  
Eradication Rate ◽  
High Rate ◽  
First Line ◽  
Helicobacter Pylori Eradication ◽  
Quadruple Therapy ◽  
First Line Therapy ◽  
Line Therapy

Background and aims: Efficacy with substitution of tetracycline with amoxicillin, an antibiotics having a very low resistance rate and a high tolerability, in bismuth quadruple therapy (BQT) have not been studied in Vietnam. Our study aimed to evaluate the efficacy and tolerability of modified BQT vs. standard BQT for first-line Helicobacter pylori eradication. Patients and methods: This is a randomized, prospective study. 120 patients with H.pylori positive-chronic gastritis were randomly divided into two groups. The RBMA group containing rabeprazole 20 mg, bismuth subsalicylic 524mg, metronidazole 500mg, amoxicillin 1000mg, all 2 times a day, for 14 days. The RBMT group received rabeprazole, bismuth subsalicylic, metronidazole and tetracycline. Evaluation for compliance and drug-related side effects were evaluated at the end of two weeks. 4-6 weeks after the end of treatment, the H.pylori eradication rate was determined by the C13urease breath test. Results: Eradication rate was not statistically significative different between the RBMA and the RBMT: 91.2%; 95% confidence interval, 78.2% - 96.7%) vs. 90%; 95% CI, 81.6% - 96.3%) by per-protocol analysis (p = 0.42) and 86.7% (95%CI, 75.84% - 93.09%) vs. 75% (95%CI, 62.1% - 85.3%) by intention-to-treat analysis (ITT, p = 0.06). Adverse effects were significant higher in the RBMT group than in the RBMA group (48.3% vs. 26.7%; p = 0.071) and rate of good compliance was significantly higher in RBMA group than in RBMT group (p < 0.05). Conclusion: The modified BQT including rabeprazole, bismuth, metronidazole and amoxicillin achieved a fairly high rate of H.pylori infection eradication with a higher compliance and lower rate of adverse effects compared to the BQT in patients with chronic gastritis. Further studies need to conduct to confirm this new regimens as a first-line therapy in our country. Key words: Modified bismuth quadruple therapy, BQT, Helicobacter pylori eradication

scholarly journals Role of endoscopy in suspicion of atrophic gastritis with and without intestinal metaplasia in comparison to histopathology

2021 ◽  
Vol 84 (1) ◽  
pp. 9-17
Author(s):  
H Ibrahim ◽  
A Shams El-Deen ◽  
ZA Kasemy ◽  
M Saad ◽  
AA Sakr
Keyword(s):  
Atrophic Gastritis ◽  
Intestinal Metaplasia ◽  
Sensitivity And Specificity ◽  
Chronic Gastritis ◽  
Gastrointestinal Symptoms ◽  
High Sensitivity ◽  
High Specificity ◽  
Poor Correlation ◽  
Gastric Lesions ◽  
Low Sensitivity

Background and study aims : Atrophic gastritis (AG) and intestinal metaplasia (IM) are established premalignant gastric lesions. Many studies documented a poor correlation between esophagogastroduodenoscopy (EGD) and histopathological (HP) findings of precancerous gastric lesions. The aim was to bridge the gap between endoscopy and HP in detection of chronic gastritis, AG and IM. Patients and methods : a prospective single-center study involved 150 patients with endoscopic criteria of gastric lesions with upper gastrointestinal symptoms referred for upper GI endoscopy met the endoscopic criteria and classified according to HP of biopsies from targeted gastric lesions into chronic gastritis (GI), AG(GII) or IM(GIII). We correlated the endoscopic criteria of the 3 groups with the HP results. Results : (73males & 75 females) with ages ranged17-75 years and mean± SD was 41.96 ± 15.95. GI, GII &GIII were [42 patients (28%),82 patients (54.7%) and 26 patients (17.3%)], respectively. Diffuse gastric mottling was more common in GI (74.3%, P<0.001), visible submucosal vessels, gastric atrophy predominated in GII (75.6, 82.3 & 73.1% (P 0.005,0.4 & <0.01)), respectively. Whitish raised lesions were more specific in GIII (85.7%) (P<0.001). The sensitivity and specificity of endoscopic suspicion of chronic gastritis were (86&88% in GI), (87&85% in GII) and (54% &100% in GIII) (p-0.001). The logistic regression model for risk factors was χ2= 25.74 and 49.32, p < 0.001. Conclusion : Conventional endoscopy has high sensitivity and specificity for suspicion of chronic gastritis and AG, but low sensitivity and very high specificity for IM. Targeted biopsies may be valuable with image enhanced techniques.

scholarly journals Clinical Recommendations of Russian Gastroenterological Association and RENDO Endoscopic Society on Diagnosis and Treatment of Gastritis and Duodenitis

2021 ◽  
Vol 31 (4) ◽  
pp. 70-99
Author(s):  
V. T. Ivashkin ◽  
I. V. Maev ◽  
T. L. Lapina ◽  
E. D. Fedorov ◽  
A. A. Sheptulin ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Atrophic Gastritis ◽  
Intestinal Metaplasia ◽  
Chronic Gastritis ◽  
Eradication Therapy ◽  
Targeted Biopsy ◽  
High Quality ◽  
Familial History ◽  
History Of ◽  
H Pylori

Aim. The clinical guidelines are intended to supplement specialty decision-making for improved aid quality in patients with gastritis and duodenitis though acknowledging the latest clinical evidence and principles of evidencebased medicine.Key points. Gastritis is an inflammatory disease of stomach mucosa, with a separate definition of acute and chronic gastritis. Chronic gastritis is a cohort of chronic diseases uniting a typical morphology of persistent inflammatory infiltration, impaired cellular renewal with emergent intestinal metaplasia, atrophy and epithelial dysplasia of gastric mucosa. Oesophagogastroduodenoscopy (OGDS) or high-resolution OGDS with magnified or non-magnified virtual chromoendoscopy, including targeted biopsy for atrophy and intestinal metaplasia grading and neoplasia detection, are recommended to verify gastritis and duodenitis, precancer states and/or gastric mucosal changes. All chronic gastritis patients positive for H. рylori should undergo eradication therapy as aetiological and subsidiary for gastric cancer prevention. Chronic gastritis patients with symptoms of dyspepsia (epigastric pain, burning and congestion, early satiety), also combined with functional dyspepsia, are recommended proton pump inhibitors, prokinetics, rebamipide and bismuth tripotassium dicitrate in symptomatic treatment. With focal restricted intestinal metaplasia, follow-up is not required in most cases, mainly when advanced atrophic gastritis is ruled out in high-quality endoscopy with biopsy. However, a familial history of gastric cancer, incomplete intestinal metaplasia and persistent H. pylori infection render endoscopy monitoring with chromoendoscopy and targeted biopsy desirable once in three years. Patients with advanced atrophic gastritis should have high-quality endoscopy every 3 years, and once in 1–2 years if complicated with a familial history of gastric cancer.Conclusion. The recommendations condense current knowledge on the aetiology and pathogenesis of gastritis and duodenitis, as well as laboratory and instrumental diagnostic techniques, main approaches to aetiological H. pylori eradication and treatment of dyspeptic states.

scholarly journals The Exploration of the Clinical Treatment of Chronic Atrophic Gastritis

2019 ◽  
Vol 2 (4) ◽  
pp. 6
Author(s):  
Eerdunbagena Ning
Keyword(s):  
Length Of Stay ◽  
Adverse Effects ◽  
Atrophic Gastritis ◽  
Eradication Rate ◽  
Chronic Atrophic Gastritis ◽  
Clinical Treatment ◽  
Control Group ◽  
Observation Group ◽  
Treatment Efficiency ◽  
H Pylori

Purpose: To explore the effect of the clinical treatment of chronic atrophic gastritis Method: 70 patients with chronic atrophic gastritis treated in our hospital from October 2017 to November 2018 were selected and randomly divided into an observation group and a control group with 35 patients in each group. The control group received standard triad treatment with gastroprokinetic drug orally. On the basis of the control group, patients in the observation group received Xianlu Pazhu Wan. The treatment efficiency, eradication rate of helicobacter pylori (H. pylori), incidence of adverse effects and length of stay were compared between the two groups. Result: Compared with the control group, patients in the observation group had a higher treatment efficiency, higher H. pylori eradication rate, lower incidence of adverse effects, and shorter length of stay with statistical significance (P< 0.05). Conclusion: In the clinical treatment of patients with chronic atrophic gastritis, adding Xianlu Pazhu Wan into the basic medication plan can have a better treatment efficiency, reduce the incidence of adverse effects, and shorten the length of stay. Therefore, Xianlu Pazhu Wan should be promoted in the practice. 

NTESTINAL METAPLASIA AND HELICOBACTER PYLORI INFECTION IN PATIENTS WITH CHRONIC GASTRITIS.

2011 ◽  
pp. 63-71
Author(s):  
Keyword(s):  
Gastric Cancer ◽  
Helicobacter Pylori ◽  
Atrophic Gastritis ◽  
Intestinal Metaplasia ◽  
Chronic Gastritis ◽  
Significant Relationship ◽  
Precancerous Lesion ◽  
Chronic Atrophic Gastritis ◽  
Helicobacter Pylori Infection ◽  
Antral Gastritis

Background: Intestinal metaplasia is a precancerous lesion. Helicobacter pylori is identified as an important cause of gastric cancer. This study is aimed at assessing the intestinal metaplasia and Helicobacter pylori infection and their relation in patients with chronic gastritis. Patients and methods: Study includes 75 patients with chronic gastritis diagnosed by clinical, endoscopic and histopathological criteria. Intestinal metaplasia is diagnosed by HE stain. Hp infection is tested by CLO-test from Viet A Ltd. Results: Hp infecton rate in this study is 66.67% and is highest in patients with antral gastritis. Intestinal metaplasia is found in 29.33% of patients with chronic gastritis with the predominance of complete intestinal metaplasia. The rate of intestinal metaplasia is the highest in the group with chronic atrophic gastritis. There is a significant relationship between intestinal metaplasia and Hp ìnfection. Conclusion: Hp and intestinal metaplasia are found at significant rates in chronic gastritis. The rate of intestinal metaplasia is clearly higher in the group with Hp-positive chronic gastritis.

scholarly journals Association of Helicobacter pylori vacA polymorphisms with the risk of gastric precancerous lesions in a Moroccan population

2021 ◽  
Vol 15 (08) ◽  
pp. 1124-1132
Author(s):  
Mohamed Reda Jouimyi ◽  
Ghizlane Bounder ◽  
Imane Essaidi ◽  
Hasna Boura ◽  
Wafaa Badre ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
High Risk ◽  
Atrophic Gastritis ◽  
Intestinal Metaplasia ◽  
Chronic Gastritis ◽  
Precancerous Lesions ◽  
Gastric Lesions ◽  
D Region ◽  
Reliable Marker ◽  
H Pylori

Introduction: Helicobacter pylori infection is the major risk factor of atrophic gastritis and intestinal metaplasia. The vacA gene is one of the most virulence factors of H. pylori and genetic diversity in its s, m, i, and d regions is associated with gastric lesions severity. This study aimed to investigate the association of vacA s, m, i, and d regions with the risk of atrophic gastritis and intestinal metaplasia in a Casablanca population. Methodology: A total of 210 patients suffering from gastric lesions (chronic gastritis, atrophic gastritis, and intestinal metaplasia) were enrolled. The type of lesion was diagnosed by histological examination. Detection of H. pylori infection and genotyping of vacA regions were carried out by PCR. Results: The prevalence of H. pylori was 95%. The most common vacA genotypes were s2 (51.5%), m2 (77%), i2 (60.5%), and d2 (58.5%). VacA s1, m1, and i1 genotypes were associated with a high risk of intestinal metaplasia, while the vacA d1 genotype increases the risk of atrophic gastritis and intestinal metaplasia. The most common vacA combination was s2/m2/i2/d2 (52%), and it was more detected in chronic gastritis. The moderate virulent vacA combination (s1/m2/i1/d1) increases the risk of atrophic gastritis, while the most virulent vacA combination (s1/m1/i1/d1) increases the risk of intestinal metaplasia. Conclusions: Genotyping of vacA d region might be a reliable marker for the identification of vacA virulent strains that represent a high risk of developing precancerous lesions (atrophic gastritis and intestinal metaplasia).

scholarly journals Association of eating habits and clinical symptoms in atrophic gastritis patients

2021 ◽  
Vol 63 (7) ◽  
pp. 11-16
Author(s):  
Tran Tien Dao ◽  
◽  
Truong Khanh Vu ◽  
Thi Thuy Ngan Phi ◽  
Cong Long Nguyen ◽  
...  
Keyword(s):  
Atrophic Gastritis ◽  
Protective Factor ◽  
Clinical Symptoms ◽  
Eating Habits ◽  
Epigastric Pain ◽  
Cross Sectional Study ◽  
Dietary Factors ◽  
Gastric Diseases ◽  
Cross Sectional ◽  
Daily Food

Atrophic gastritis is one of the most common gastric diseases, and many risk factors may increase the risk. This study aimed to assess the relationship between dietary factors and clinical symptoms of patients with atrophic gastritis. A cross-sectional study was conducted from October 2018 to October 2020 in the Center of Gastroenterology and Hepatology of Bach Mai Hospital with a total of 3508 atrophic gastritis patients aged ≥40 years (female/male ratio was 1.68). All patients were interviewed based on a designed questionnaire and underwent a gastroscopy procedure. The most common symptoms were epigastric pain (73.9%), belching/heartburn (42.4%), the feeling of fullness (41%), reflux symptom (15.4%). A majority of patients had mild atrophic gastritis (C1, C2) (80.4%), followed by moderate atrophic gastritis (C3, O1) (17%), and severe atrophic gastritis (O2, O3) (2.6%). A diet with much deep-fried or grilled food increased the risk of epigastric pain (OR 1.343; 95%CI 1.002-1.801); diets with much meat or nuts increased the risk of the feeling of fullness (meat: OR 1.296; 95%CI 1.100-1.526 and nuts: OR 1.316; 95%CI 1.033-1.676), and belching/heartburn (meat: OR 1.243; 95%CI 1.058-1.461 and nuts: OR 1.376; 95%CI 1.082-1.751). Diets with much salt or nuts increased the risk of reflux symptoms (salt: OR 1.359; 95%CI 1.055-1.752 and nuts: OR 1.532; 95%CI 1.023-2.293). A diet with many vegetables was a protective factor that can help to decrease the risk of moderate and severe atrophic gastritis (OR 0.616; 95%CI 0.403-0.941). In conclusion, diets and food types are factors that affect the risk of clinical symptoms among patients with atrophic gastritis, so the action of adjusting diets and daily food also play an important role in atrophic gastritis.

scholarly journals Chronic Gastritis in Dermatitis Herpetiformis: A Controlled Study

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Anna Alakoski ◽  
Teea T. Salmi ◽  
Kaisa Hervonen ◽  
Hannu Kautiainen ◽  
Maarit Salo ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Atrophic Gastritis ◽  
Intestinal Metaplasia ◽  
Chronic Gastritis ◽  
Dermatitis Herpetiformis ◽  
Villous Atrophy ◽  
Chronic Atrophic Gastritis ◽  
Controlled Study ◽  
Gastric Corpus ◽  
H Pylori

Background and Objective. Previous small studies suggest that chronic atrophic gastritis is common in dermatitis herpetiformis (DH). We here examined the frequency and topography of chronic gastritis in 93 untreated DH subjects and in 186 controls with dyspepsia.Methods. Specimens were drawn from the gastric corpus and antrum and examined for atrophy, intestinal metaplasia, andHelicobacter pylori. Duodenal biopsies were taken.Results. Atrophic corpus gastritis was more frequent in DH than in controls (16.0% and 2.7%, resp.,P<0.001); atrophy in the antrum was rare in both groups (3.2% and 1.1%,P=0.34). Intestinal metaplasia was present in 13 (14.0%) DH and 12 (6.5%) control patients (P=0.038) andH. pyloriin 17 (18.3%) and 17 (9.3%) (P=0.028), respectively. Small-bowel villous atrophy was seen in 76% of the DH patients, equally in patients with and without chronic gastritis. One DH patient with atrophic gastritis developed gastric cancer.Conclusion. In DH, chronic atrophic gastritis was common in the corpus, but not in the antrum.H. pyloriwill partly explain this, but corpus atrophy is suggestive of an autoimmune etiology. Atrophic gastritis may increase the risk of gastric cancer. We advocate performing upper endoscopy with sufficient histologic samples in DH.

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