[Show abstract][Hide abstract] ABSTRACT: In the developed countries, the prevalence of infection by H. Pylori among patients with active chronic gastritis (ACG) and peptic ulcer is diminishing. In developing countries, as far as it is known, neither a time variation of this infection nor a related epidemiological phenomena have been reported.
Determine the changes in the prevalence of H. pylori in patients from medium and high socio-economic strata in Lima, with ACG and peptic ulcer from 1985 to 2002.
An evaluation by means of an esophago-gastroduodenoscopy was carried out in a private hospital in 1,815 patients from the medium and upper socio-economic strata, all of them residents in Lima, Peru and showing upper gastrointestinal tract symptoms. Coloring with hematoxilin-eosin was used.
1,260 patients with ACG were identified: 178 with duodenal ulcer, 55 with gastric ulcer and 292 with histologically normal gastric mucose (HNGM). Prevalence of H. pylori among patients with ACG dropped from 83.3% to 58.7% (p<0.001) in males and females under 30 years old and from 31 to 50 years old (p=0.001). In patients with duodenal ulcer it decreased from 89.5% to 71.9% (p=0.004) and in those patients with gastric ulcer, from 84.8% to 77.3% (p=0.36). In patients with HNGM, prevalence remained the same (from 2.7% to 0.0%) (p=0.15).
Between 1985 and 2002, in Lima, Peru, H. pylori prevalence in patients from the medium and upper socio-economic strata, with ACG and peptic ulcer, diminished.
Revista de gastroenterologia del Peru: organo oficial de la Sociedad de Gastroenterologia del Peru 01/2003; 23(2):92-8.
[Show abstract][Hide abstract] ABSTRACT: The most accepted treatment for infection by Helicobacter pylori is the proton pump inhibitor based therapy with two antibiotics. However, there is no consensus regarding the duration. The purpose here was to compare eradication percentages in the omeprazole+amoxicillin+clarithromycin regimen administered during 7 days versus 10 days and confront the results with a previous 14-day* experience in Peru.
Patients from the Central Military Hospital and Peruvian-Japanese Hospital evidencing chronic upper gastrointestinal tract symptoms were recruited. We excluded patients with peptic ulcer. Biopsies were taken for diagnosis, for urease and PCR tests, culture and coloring with silver. Omeprazole+clarithromycin+amoxicillin was used during 7 days versus 10 days. Control endoscopy was performed one month after treatment had been completed and molecular biology techniques were used to differentiate recurrences from new infections. Susceptibility to clarithromycin was assessed.
36 patients were included in each group. Eradication was the same in both groups: 86.1% (31/36). In several patients in whom the bacteria persisted, the same initial nucleus was found. In a previous study* using this same regimen during 14 days, a 93% eradication was obtained. 91.18% of our samples were susceptible to clarithromycin.
In Peru, the omeprazole+clarithromycin+amoxicillin combination gives results higher than 80% in the eradication of infection by Helicobacter pylori. The 7 and 10 days regimens eradicated the bacteria in 86% of our patients.
Revista de gastroenterologia del Peru: organo oficial de la Sociedad de Gastroenterologia del Peru 01/2003; 23(3):177-83.
[Show abstract][Hide abstract] ABSTRACT: SUMMARY The important contribution of several researchers on the characteristics of H. pylori infection in Peru is shown in this article. Epidemiology: the onset of the infection is at early stages of life. The most important way of trasmission is the fecal-oral route and by water. The prevalence in low socioeconomic population is similar for the coast, mountain and jungle. The prevalence of H. pylori infection is decreasing among medium to high socioeconomic status (related to peptic ulcer and gastric cancer reduction) and it is still constant among people from low socioeconomic status. There is no evidence that a certain race is more susceptible to acquire this infection. The prevalence of chronic atrophic gastritis is higher in people from high altitude areas compared to that people living at sea level. Microbiology, molecular biology and pathology: Peruvian H. pylori strains are similar to those from Spain and Europe and ther are very different from those proceeding from Japan and China. Chronic superficial gastritis, chronic deep gastritis and chronic atrophic gastritis are different stages of the inflammatory injury produced by the bacteria in the stomach. Diagnosis: stomach biopsy using silver staining is the gold standard. The combination of two techniques can be helpful. Treatment: triple drug therapy provides an eradication rate higher than 80%. The use of regimens containing two drugs or one drug are not enough. The rate of postreatment relapse is high and it it mostly produced by a different strain.