Online ISSN: 2515-8260

Keywords : H.pylori


Significant endoscopic findings and the probable associated factors in dyspeptic patients: A cross-sectional study conducted in a tertiary care hospital, rural Mandya

Dr. Yamuna VS, Dr. Sachin K, Dr. Selva Rani, Dr. Veena Ghanteppagol, Dr. Ullas Mahesh

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 5, Pages 382-390

Introduction: Dyspepsia is the most common gastrointestinal problem. Majority of dyspepsia is functional dyspepsia. Due to the high prevalence of dyspepsia, inappropriate use of upper GI Endoscopy can lead to unnecessary costs, risk of complications, and associated with reduced diagnostic yield.
Objectives:

To determine the prevalence of significant endoscopic finding (SEF) and H.Pylori in dyspeptic patients.
To determine the response of dyspeptic patients to PPIs and H.pylori eradication therapy.
To assess the factors predicting SEF in dyspeptic patients.

Materials and Methods: This was a cross-sectional study conducted for a period of 18 months among 100 patients with dyspepsia at department of general surgery of a tertiary care hospital. Data was collected using a semi-structured questionnaire by interview technique. The study subjects were subjected to upper gastro-intestinal endoscopy during which biopsies were taken and sent for routine histopathology examination. Descriptive and inferential statistics has been carried out in the present study. A P value < 0.05 was considered statistically significant.
Results: The mean age of the study subjects was 45.13±14.06 years. Pain abdomen was the commonest (82.0%) alarm symptom of dyspepsia and 64.0% of those with dyspepsia were smokers and 61.0% were alcoholics. Overall prevalence of significant endoscopic finding (SEF) was 36.0% and duodenal ulcer (22.0%) was the commonest of all. 71.0% revealed H.pylori infection and at least 90.0% responded well to proton pump inhibitors (PPIs) and triple drug therapy. Among the different factors, bloating or belching was found to be significantly associated with the SEF.
Conclusion: The prevalence of SEF was 36.0% and H.pylori was 71.0%. Most of them i.e. 90.0% responded both clinically and microbiologically to the treatment and bloating or belching was a significant alarm symptom associated with SEF. A trial of proton pump inhibitors (PPIs) and triple drug therapy can be considered before subjecting the patients to the invasive procedure of endoscopy.

ROLE OF DIETARY POLYPHENOLS IN THE MANAGEMENT OF PEPTIC ULCER

Barani Shankar; Jayalakshmi Somasundaram; Lakshminarayanan Arivarasu

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 1, Pages 1541-1546

Peptic ulcer disease is a multifactorial and complex disease involving gastric and duodenal ulcers. Despite medical advances, the management of peptic ulcer and its complications remains a challenge. An accumulating body of evidence suggests that, among a broad reach of natural molecules, dietary polyphenols with multiple biological mechanisms of action play a pivotal part in the management of gastric and duodenal ulcers. The current review confirmed that dietary polyphenols possess protective and therapeutic potential in peptic ulcer mediated by: improving cytoprotection, re-epithelialization, neovascularization, and angiogenesis; up-regulating tissue growth factors and prostaglandins; down-regulating anti-angiogenic factors; enhancing endothelial nitric oxide synthase-derived NO; suppressing oxidative mucosal damage; amplifying antioxidant performance, antacid, and anti-secretory activity; increasing endogenous mucosal defensive agents; and blocking helicobacter pylori colonization associated gastric morphological changes and gastroduodenal inflammation and ulceration. In addition, anti-inflammatory activity due to down-regulation of proinflammatory cytokines and cellular and intercellular adhesion agents, suppressing leukocyte-endothelium interaction, inhibiting nuclear signaling pathways of inflammatory process, and modulating intracellular transduction and transcription pathways have key roles in the anti-ulcer action of dietary polyphenols.Polyphenols ubiquitously present in vegetables and fruits are progressively viewed as natural dietary ingredients vital for a balanced diet. Administration of a sufficient amount of dietary polyphenols in the human diet can result in perfect prevention and treatment of peptic ulcer. In conclusion, administration of a significant amount of dietary polyphenols in the human diet or as part of dietary supplementation along with conventional treatment can result in perfect security and treatment of peptic ulcer. Further well-designed preclinical and clinical tests are recommended in order to recognize higher levels of evidence for the confirmation of bioefficacy and safety of dietary polyphenols in the management of peptic ulcer