ASSOCIATING H. PYLORI BACTERIAL DENSITY WITH UPPER GI SYMPTOMS AND ENDOSCOPIC FINDINGS: A CROSS-SECTIONAL STUDY
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Keywords
Helicobacter pylori, bacterial density, gastric inflammation, gastritis, esophagitis, gastrointestinal symptoms.
Abstract
Objective: To examine the association between Helicobacter pylori density of gastric mucosal biopsy and the severity of gastric mucosal inflammation and evaluate the relationship with endoscopic findings and upper gastrointestinal symptoms in endoscopic patients.
Study Design: This was a cross-sectional study.
Place and Duration: This study was conducted at Al Tibri Medical College and Hospital ISRA, University Karachi Campus Pakistan from August 2024 to August 2025
Methods: Ninety-two patients with upper gastrointestinal symptoms underwent endoscopy with gastric antral biopsies. Biopsies were stained with hematoxylin and eosin and Giemsa and were graded for gastritis and H. pylori density by one histopathologist using the Sydney System (0-3 and 0-6 scales, respectively). Patients on anti-H. pylori therapy were excluded. Data was analyzed using SPSS 20.0, using Chi-Square tests and Pearson correlation with a p<0.05.
Results: Among 92 patients (59.8% female, mean age 39.21 ± 13.48 years), 65.2% (n=60) had no H. pylori, 10.9% (n=10) mild, 16.3% (n=15) moderate, and 7.6% (n=7) severe density. Antral gastritis and duodenitis each affected 65.2% (n=60), esophagitis 65.2% (n=60), gastric and duodenal ulcers 5.4% (n=5), mild gastritis 5.4% (n=5), moderate gastritis 37.8% (n=35), and severe gastritis 21.7% (n=20). Epigastric pain occurred in 76.1% (n=70) patients, nausea in 54.3% (n=50), retrosternal burning in 49.0% (n=45), and hematemesis in 2.2% (n=2). Esophagitis was significantly correlated with increased H. pylori density (p<0.001). Moderate gastritis (p=0.077), duodenitis (p=0.326), and vomiting (p=0.206) were non-significant trends, and all other symptoms and findings were non-associated (p=0.221- 0.966).
Conclusion: Higher H. pylori density is significantly associated with the severity of esophagitis but not with most gastrointestinal symptoms or other endoscopic findings. Future multicenter studies may elucidate these relationships.
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
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Waqas Manzoor
Assistant Professor Gastroenterology, Al Tibri Medical College and Hospital ISRA, University Karachi Campus Pakistan.
Faizan Ali Memon
Senior Registrar Gastroenterology, Indus Medical College Tando Muhammad Khan Pakistan.
Dolat Singh
Assistant Professor Medicine, Indus Medical College Tando Muhammad Khan Pakistan.
Muhammad Awais Memon
Senior Registrar Medicine, Indus Medical College Tando Muhammad Khan Pakistan.
Hassan Liaquat Memon
Assistant Professor Gastroenterology, United Medical and Dental College, United hospital Karachi Pakistan.
Chaman Das
Assistant Professor Gastroenterology, Muhammad Medical College (Ibn-E-Sina University) Mirpurkhas Pakistan.