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Erschienen in: Indian Journal of Gastroenterology 1/2011

01.02.2011 | Original Article

Helicobacter pylori negative, non-steroidal anti-inflammatory drug-negative peptic ulcers in India

verfasst von: Mahesh Kumar Goenka, Shounak Majumder, Pradeepta Kumar Sethy, Madhurima Chakraborty

Erschienen in: Indian Journal of Gastroenterology | Ausgabe 1/2011

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Abstract

Introduction

The past decade has witnessed a global rise in the prevalence of peptic ulcer disease which is unrelated to non-steroidal anti-inflammatory drugs (NSAIDs) or Helicobacter pylori infection. Although initially recognized in the West, this disease is being increasingly recognized in the Asian population. The higher risk of bleeding and ulcer recurrence in this subgroup of patients highlights the clinical importance of analyzing the changing trends of peptic ulcer disease in developing countries.

Aims

To assess the proportion of non-NSAID, non-H. pylori peptic ulcer disease in an Indian cohort of patients with peptic ulcer disease managed at a tertiary care center; and to compare the gastric and duodenal ulcer subgroups in these patients.

Methods

Patients diagnosed with peptic ulcer disease were screened for a history of NSAID use and those with a negative history were tested for H. pylori using a combination of rapid urease test (RUT) and 14C-urea breath test (UBT). Only those cases which tested negative for both the tests were considered ‘H. pylori-negative’. Serum gastrin was measured in all patients included in the study.

Results

Seventy-four gastric ulcer (GU) and 54 duodenal ulcer (DU) patients with no history of NSAID use were enrolled. Of these, 36 GU (45.9%) and 16 DU (29.6%) patients were H. pylori-negative. The proportion of non-NSAID non-H. pylori gastric ulcers was significantly higher than duodenal ulcers (p < 0.05). However, patients who tested negative for H. pylori did not differ significantly from those who tested positive with regard to age, gender, serum gastrin level, and presence of risk factors, like smoking and alcoholism.

Conclusion

The current study indicates existence of high proportion of non-NSAID, non-H. pylori peptic ulcer disease in Indian patients.
Literatur
1.
Zurück zum Zitat Arroyo MT, Forne M, de Argila CM, et al. The prevalence of peptic ulcer not related to Helicobacter pylori or non-steroidal anti inflammatory drug use is negligible in Southern Europe. Helicobacter. 2004;9:249–54.PubMedCrossRef Arroyo MT, Forne M, de Argila CM, et al. The prevalence of peptic ulcer not related to Helicobacter pylori or non-steroidal anti inflammatory drug use is negligible in Southern Europe. Helicobacter. 2004;9:249–54.PubMedCrossRef
2.
Zurück zum Zitat Jyotheeswaran S, Shah AN, Jim HO, et al. Prevalence of Helicobacter pylori in peptic ulcer patients in Great Rochester, NY: is empirical triple therapy justified? Am J Gastroenterol. 1998;93:574–8.PubMedCrossRef Jyotheeswaran S, Shah AN, Jim HO, et al. Prevalence of Helicobacter pylori in peptic ulcer patients in Great Rochester, NY: is empirical triple therapy justified? Am J Gastroenterol. 1998;93:574–8.PubMedCrossRef
3.
Zurück zum Zitat Tan HJ, Goh KL. Changing epidemiology of Helicobacter pylori in Asia. J Dig Dis. 2008;9:186–9.PubMedCrossRef Tan HJ, Goh KL. Changing epidemiology of Helicobacter pylori in Asia. J Dig Dis. 2008;9:186–9.PubMedCrossRef
4.
Zurück zum Zitat Fujisawa T, Kumagai T, Akamatsu T, et al. Changes in seroepidemiological pattern of Helicobacter pylori and hepatitis A virus over the last 20 years in Japan. Am J Gastroenterol. 1999;94:2094–9.PubMedCrossRef Fujisawa T, Kumagai T, Akamatsu T, et al. Changes in seroepidemiological pattern of Helicobacter pylori and hepatitis A virus over the last 20 years in Japan. Am J Gastroenterol. 1999;94:2094–9.PubMedCrossRef
5.
Zurück zum Zitat Wong GL, Wong VW, Chan Y, et al. High incidence of mortality and recurrent bleeding in patients with Helicobacter pylori-negative idiopathic bleeding ulcers. Gastroenterology. 2009;137:525–31.PubMedCrossRef Wong GL, Wong VW, Chan Y, et al. High incidence of mortality and recurrent bleeding in patients with Helicobacter pylori-negative idiopathic bleeding ulcers. Gastroenterology. 2009;137:525–31.PubMedCrossRef
6.
Zurück zum Zitat Yeomans ND, Naesdal J. Systematic review: ulcer definition in NSAID ulcer prevention trials. Aliment Pharmacol Ther. 2008;27:465–72.PubMedCrossRef Yeomans ND, Naesdal J. Systematic review: ulcer definition in NSAID ulcer prevention trials. Aliment Pharmacol Ther. 2008;27:465–72.PubMedCrossRef
7.
Zurück zum Zitat Hegedus O, Rydén J, Rehnberg AS, et al. Validated accuracy of a novel urea breath test for rapid Helicobacter pylori detection and in-office analysis. Eur J Gastroenterol Hepatol. 2002;14:513–20.PubMedCrossRef Hegedus O, Rydén J, Rehnberg AS, et al. Validated accuracy of a novel urea breath test for rapid Helicobacter pylori detection and in-office analysis. Eur J Gastroenterol Hepatol. 2002;14:513–20.PubMedCrossRef
8.
Zurück zum Zitat Borody TJ, George LL, Brandl S, et al. Helicobacter pylori-negative duodenal ulcer. Am J Gastroenterol. 1991;86:1154–7.PubMed Borody TJ, George LL, Brandl S, et al. Helicobacter pylori-negative duodenal ulcer. Am J Gastroenterol. 1991;86:1154–7.PubMed
9.
Zurück zum Zitat Borody TJ, Brandl S, Andrews P, et al. Helicobacter pylori-negative gastric ulcer. Am J Gastroenterol. 1992;87:1403–6.PubMed Borody TJ, Brandl S, Andrews P, et al. Helicobacter pylori-negative gastric ulcer. Am J Gastroenterol. 1992;87:1403–6.PubMed
10.
Zurück zum Zitat Xia HH, Phung N, Kalantar JS, et al. Demographic and endoscopic characteristics of patients with Helicobacter pylori positive and negative peptic ulcer disease. Med J Aust. 2000;173:515–9.PubMed Xia HH, Phung N, Kalantar JS, et al. Demographic and endoscopic characteristics of patients with Helicobacter pylori positive and negative peptic ulcer disease. Med J Aust. 2000;173:515–9.PubMed
11.
Zurück zum Zitat Gisbert JP, Blanco M, Mateos JM, et al. H. pylori-negative duodenal ulcer prevalence and causes in 774 patients. Dig Dis Sci. 1999;44:2295–302.PubMedCrossRef Gisbert JP, Blanco M, Mateos JM, et al. H. pylori-negative duodenal ulcer prevalence and causes in 774 patients. Dig Dis Sci. 1999;44:2295–302.PubMedCrossRef
12.
Zurück zum Zitat Bytzer P, Danish Ulcer Study Group. Helicobacter pylori-negative duodenal ulcers: prevalence, clinical characteristics, and prognosis—results from a randomized trial with 2-year follow-up. Am J Gastroenterol. 2001;96:1409–16.PubMed Bytzer P, Danish Ulcer Study Group. Helicobacter pylori-negative duodenal ulcers: prevalence, clinical characteristics, and prognosis—results from a randomized trial with 2-year follow-up. Am J Gastroenterol. 2001;96:1409–16.PubMed
13.
Zurück zum Zitat Oderda G, Mura S, Valori A, et al. Idiopathic peptic ulcers in children. J Pediatr Gastroenterol Nutr. 2009;48:268–70.PubMedCrossRef Oderda G, Mura S, Valori A, et al. Idiopathic peptic ulcers in children. J Pediatr Gastroenterol Nutr. 2009;48:268–70.PubMedCrossRef
14.
Zurück zum Zitat Nishikawa K, Sugiyama T, Kato M, et al. Non-Helicobacter pylori, non-NSAID peptic ulcer disease in the Japanese population. Eur J Gastroenterol Hepatol. 2000;12:635–40.PubMedCrossRef Nishikawa K, Sugiyama T, Kato M, et al. Non-Helicobacter pylori, non-NSAID peptic ulcer disease in the Japanese population. Eur J Gastroenterol Hepatol. 2000;12:635–40.PubMedCrossRef
15.
Zurück zum Zitat Chan HL, Wu JC, Chan FK, et al. Is non-Helicobacter pylori, non-NSAID peptic ulcer a common cause of upper GI Bleeding? A prospective study of 977 patients. Gastrointest Endosc. 2001;53:438–42.PubMedCrossRef Chan HL, Wu JC, Chan FK, et al. Is non-Helicobacter pylori, non-NSAID peptic ulcer a common cause of upper GI Bleeding? A prospective study of 977 patients. Gastrointest Endosc. 2001;53:438–42.PubMedCrossRef
16.
Zurück zum Zitat Hung LC, Ching JY, Sung JJ, et al. Long-term outcome of Helicobacter pylori-negative idiopathic bleeding ulcers: a prospective cohort study. Gastroenterology. 2005;128:1845–50.PubMedCrossRef Hung LC, Ching JY, Sung JJ, et al. Long-term outcome of Helicobacter pylori-negative idiopathic bleeding ulcers: a prospective cohort study. Gastroenterology. 2005;128:1845–50.PubMedCrossRef
17.
Zurück zum Zitat Ciociola AA, McSorley DJ, Turner K, et al. Helicobacter pylori infection rates in duodenal ulcer patients in the United States may be lower than previously estimated. Am J Gastroenterol. 1999;94:1834–40.PubMedCrossRef Ciociola AA, McSorley DJ, Turner K, et al. Helicobacter pylori infection rates in duodenal ulcer patients in the United States may be lower than previously estimated. Am J Gastroenterol. 1999;94:1834–40.PubMedCrossRef
18.
Zurück zum Zitat Hobsley M, Tovey FI. Helicobacter pylori: the primary cause of duodenal ulceration or a secondary infection? World J Gastroenterol. 2001;7:149–51.PubMed Hobsley M, Tovey FI. Helicobacter pylori: the primary cause of duodenal ulceration or a secondary infection? World J Gastroenterol. 2001;7:149–51.PubMed
19.
Zurück zum Zitat Tovey FI, Hobsley M. Is Helicobacter pylori the primary cause of duodenal ulceration? J Gastroenterol Hepatol. 1999;14:1053–6.PubMedCrossRef Tovey FI, Hobsley M. Is Helicobacter pylori the primary cause of duodenal ulceration? J Gastroenterol Hepatol. 1999;14:1053–6.PubMedCrossRef
20.
Zurück zum Zitat Chow DK, Sung JJ. Non-NSAID non-H. pylori ulcer disease. Best Pract Res Clin Gastroenterol. 2009;23:3–9.PubMedCrossRef Chow DK, Sung JJ. Non-NSAID non-H. pylori ulcer disease. Best Pract Res Clin Gastroenterol. 2009;23:3–9.PubMedCrossRef
21.
Zurück zum Zitat McColl KE. How I manage H. pylori-negative, NSAID/aspirin negative peptic ulcers. Am J Gastroenterol. 2009;104:190–3.PubMedCrossRef McColl KE. How I manage H. pylori-negative, NSAID/aspirin negative peptic ulcers. Am J Gastroenterol. 2009;104:190–3.PubMedCrossRef
22.
Zurück zum Zitat Meucci G, Di Battista R, Abbiati C, et al. Prevalence and risk factors of Helicobacter pylori-negative peptic ulcer. J Clin Gastroenterol. 2000;31:42–7.PubMedCrossRef Meucci G, Di Battista R, Abbiati C, et al. Prevalence and risk factors of Helicobacter pylori-negative peptic ulcer. J Clin Gastroenterol. 2000;31:42–7.PubMedCrossRef
23.
Zurück zum Zitat Higuchi K, Arakawa T, Fujiwara Y, et al. Is Helicobacter pylori-negative duodenal ulcer masked by the high prevalence of H. pylori infection in the general population? Am J Gastroenterol. 1999;94:3083–4.PubMedCrossRef Higuchi K, Arakawa T, Fujiwara Y, et al. Is Helicobacter pylori-negative duodenal ulcer masked by the high prevalence of H. pylori infection in the general population? Am J Gastroenterol. 1999;94:3083–4.PubMedCrossRef
24.
Zurück zum Zitat Vu C, Ng YY. Prevalence of Helicobacter pylori in peptic ulcer disease in a Singapore Hospital. Singapore Med J. 2000;41:478–81.PubMed Vu C, Ng YY. Prevalence of Helicobacter pylori in peptic ulcer disease in a Singapore Hospital. Singapore Med J. 2000;41:478–81.PubMed
25.
Zurück zum Zitat Yakoob J, Jafri W, Jafri N, et al. Prevalence of non-Helicobacter pylori duodenal ulcer in Karachi, Pakistan. World J Gastroenetrol. 2005;11:3562–5. Yakoob J, Jafri W, Jafri N, et al. Prevalence of non-Helicobacter pylori duodenal ulcer in Karachi, Pakistan. World J Gastroenetrol. 2005;11:3562–5.
26.
Zurück zum Zitat Mishra S, Singh V, Rao GR, et al. Prevalence of Helicobacter pylori in asymptomatic subjects—a nested PCR based study. Infect Genet Evol. 2008;8:815–9.PubMedCrossRef Mishra S, Singh V, Rao GR, et al. Prevalence of Helicobacter pylori in asymptomatic subjects—a nested PCR based study. Infect Genet Evol. 2008;8:815–9.PubMedCrossRef
27.
Zurück zum Zitat Jain A, Buddhiraja S, Khurana B, et al. Risk factors for duodenal ulcer in north India. Trop Gastroenterol. 1999;20:36–9.PubMed Jain A, Buddhiraja S, Khurana B, et al. Risk factors for duodenal ulcer in north India. Trop Gastroenterol. 1999;20:36–9.PubMed
28.
Zurück zum Zitat Singh V, Trikha B, Nain CK, et al. Epidemiology of Helicobacter pylori and peptic ulcer in India. J Gastroenterol Hepatol. 2002;17:659–65.PubMedCrossRef Singh V, Trikha B, Nain CK, et al. Epidemiology of Helicobacter pylori and peptic ulcer in India. J Gastroenterol Hepatol. 2002;17:659–65.PubMedCrossRef
29.
Zurück zum Zitat Quan C, Talley NJ. Management of peptic ulcer disease not related to Helicobacter pylori or NSAIDs. Am J Gastroenterol. 2002;97:2950–61.PubMedCrossRef Quan C, Talley NJ. Management of peptic ulcer disease not related to Helicobacter pylori or NSAIDs. Am J Gastroenterol. 2002;97:2950–61.PubMedCrossRef
30.
Zurück zum Zitat Kemppainen H, Raiha I, Sourander L. Clinical presentation of peptic ulcer in the elderly. Gerontology. 1997;43:283–8.PubMedCrossRef Kemppainen H, Raiha I, Sourander L. Clinical presentation of peptic ulcer in the elderly. Gerontology. 1997;43:283–8.PubMedCrossRef
31.
Zurück zum Zitat Malfertheiner P, Megraud F, O’Morain C, et al. Current concepts in the management of Helicobacter pylori infection: the Maastricht III Consensus Report. Gut. 2007;56:772–81.PubMedCrossRef Malfertheiner P, Megraud F, O’Morain C, et al. Current concepts in the management of Helicobacter pylori infection: the Maastricht III Consensus Report. Gut. 2007;56:772–81.PubMedCrossRef
32.
Zurück zum Zitat Wong GLH, Ching JYL, Chan Y, et al. Long-term outcome of Helicobacter pylori-negative idiopathic bleeding ulcers: a 7-year prospective cohort study. Gastroenterology. 2008;134 Suppl 1:A75. Wong GLH, Ching JYL, Chan Y, et al. Long-term outcome of Helicobacter pylori-negative idiopathic bleeding ulcers: a 7-year prospective cohort study. Gastroenterology. 2008;134 Suppl 1:A75.
33.
Zurück zum Zitat Goenka MK, Kochhar R, Ghosh P, et al. Changing pattern of peptic ulcer in India. An endoscopic study of 1188 ulcer patients. J Clin Gastroenterol. 1991;13:575–9.PubMedCrossRef Goenka MK, Kochhar R, Ghosh P, et al. Changing pattern of peptic ulcer in India. An endoscopic study of 1188 ulcer patients. J Clin Gastroenterol. 1991;13:575–9.PubMedCrossRef
Metadaten
Titel
Helicobacter pylori negative, non-steroidal anti-inflammatory drug-negative peptic ulcers in India
verfasst von
Mahesh Kumar Goenka
Shounak Majumder
Pradeepta Kumar Sethy
Madhurima Chakraborty
Publikationsdatum
01.02.2011
Verlag
Springer-Verlag
Erschienen in
Indian Journal of Gastroenterology / Ausgabe 1/2011
Print ISSN: 0254-8860
Elektronische ISSN: 0975-0711
DOI
https://doi.org/10.1007/s12664-011-0085-9

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