Bleeding Peptic Ulcer and Helicobacter Pylori Infection

Session

Medical, Dental and Pharmaceutical Sciences

Description

The aim of this study was to investigate the prevalence of infection with H. pylori in patients with peptic ulcer bleeding, the effect of triple therapy (OAC) on the eradication of H. pylori infection, as well as the influence of H. pylori eradication in the appearance of recurrent bleeding peptic ulcer. The research group of 40 patients with positive history of bleeding from gastric or duodenal ulcers, underwent upper endoscopy and first-rate endoscopic hemostasis. The patients were examined at the Endoscopic Service of the Gastroenterology Clinic with Hepatology. The defect in the stomach wall and duodenum over 5 mm confirmed with endoscopy, symptom-defined bleeding and endoscopic signs were the main criteria for being included in this research study. After the endoscopic verification of bleeding ulcer and H. pylori status, the patients were treated with anti-secretory drugs, infusions and transfusions (when needed) and further with proton pump inhibitors, amoxicillin and clarithromycin (OAC) in standard doses. The control endoscopy was performed after 8 weeks, in order to verify the condition of ulcer and H. pylori status after eradication therapy. The eventual recurrence of peptic ulcer bleeding was followed during one year period in patients with H. pylori status.This study included 40 patients, of which 26 patients with bleeding duodenal ulcers and 14 patients with gastric bleeding ulcers. Their average age was 62.5. Out of the examined patients, 33 patients (or 82.5%) had positive result for H. pylori and 7 patients (or 17.5%) with negative H. pylori. After initiating and eradicating treatment, in 30 patients (or 91%) H. pylori eradication was successful and in 3 patients (or 9%) it was not successful. During an one-year follow-up, recurrent bleeding was reported in 4 out of 40 (or 10%) patients. In the group of H. pylori positive patients, re-bleeding occurred in 3 of 40 (or 7.5%), while in the group of patients with H. pylori negative, re-bleeding occurred in 1 out of 40 (or 2.5%) patients. After eradication, in the group with positive H. pylori, bleeding was reported in 3 of 3 (or 100%) of cases, whereas in the group with H. pylori negative patients, in 37 (or 2.7%) of cases. All three patients with positive H. pylori had recurrent hemorrhage (p <0.05 and 0.01). The prevalence of infection with H. pylori in patients with bleeding from peptic ulcer was high (82.5%). The success of triple therapy in the eradication of H. pylori from bleeding ulcers was 91%. H. pylori eradication significantly reduced the number of recurrent bleeding from peptic ulcer, (p <0.01). Detection of H. pylori infection in patients with peptic ulcer ulceration is of great importance.

Keywords:

Peptic ulcer, Bleeding, Treatment, Eradication

Session Chair

Xhevat Pllana

Session Co-Chair

Dafina Gexha Bunjaku

Proceedings Editor

Edmond Hajrizi

ISBN

978-9951-437-69-1

Location

Pristina, Kosovo

Start Date

27-10-2018 1:30 PM

End Date

27-10-2018 3:00 PM

DOI

10.33107/ubt-ic.2018.349

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Oct 27th, 1:30 PM Oct 27th, 3:00 PM

Bleeding Peptic Ulcer and Helicobacter Pylori Infection

Pristina, Kosovo

The aim of this study was to investigate the prevalence of infection with H. pylori in patients with peptic ulcer bleeding, the effect of triple therapy (OAC) on the eradication of H. pylori infection, as well as the influence of H. pylori eradication in the appearance of recurrent bleeding peptic ulcer. The research group of 40 patients with positive history of bleeding from gastric or duodenal ulcers, underwent upper endoscopy and first-rate endoscopic hemostasis. The patients were examined at the Endoscopic Service of the Gastroenterology Clinic with Hepatology. The defect in the stomach wall and duodenum over 5 mm confirmed with endoscopy, symptom-defined bleeding and endoscopic signs were the main criteria for being included in this research study. After the endoscopic verification of bleeding ulcer and H. pylori status, the patients were treated with anti-secretory drugs, infusions and transfusions (when needed) and further with proton pump inhibitors, amoxicillin and clarithromycin (OAC) in standard doses. The control endoscopy was performed after 8 weeks, in order to verify the condition of ulcer and H. pylori status after eradication therapy. The eventual recurrence of peptic ulcer bleeding was followed during one year period in patients with H. pylori status.This study included 40 patients, of which 26 patients with bleeding duodenal ulcers and 14 patients with gastric bleeding ulcers. Their average age was 62.5. Out of the examined patients, 33 patients (or 82.5%) had positive result for H. pylori and 7 patients (or 17.5%) with negative H. pylori. After initiating and eradicating treatment, in 30 patients (or 91%) H. pylori eradication was successful and in 3 patients (or 9%) it was not successful. During an one-year follow-up, recurrent bleeding was reported in 4 out of 40 (or 10%) patients. In the group of H. pylori positive patients, re-bleeding occurred in 3 of 40 (or 7.5%), while in the group of patients with H. pylori negative, re-bleeding occurred in 1 out of 40 (or 2.5%) patients. After eradication, in the group with positive H. pylori, bleeding was reported in 3 of 3 (or 100%) of cases, whereas in the group with H. pylori negative patients, in 37 (or 2.7%) of cases. All three patients with positive H. pylori had recurrent hemorrhage (p <0.05 and 0.01). The prevalence of infection with H. pylori in patients with bleeding from peptic ulcer was high (82.5%). The success of triple therapy in the eradication of H. pylori from bleeding ulcers was 91%. H. pylori eradication significantly reduced the number of recurrent bleeding from peptic ulcer, (p <0.01). Detection of H. pylori infection in patients with peptic ulcer ulceration is of great importance.