engleski

Histology versus urea breath test in patients with gastritis without histologicaly detectable infection

Introduction: in group of this selected patients. Histological evaluation of gastric mucosa is standard procedure in detection of Helicobacter pylori infection and eradication treatment success. Recommended endoscopic examination procedure includes minimum two biopic samples of gastric mucosa. Urea breath test is routinely used in detection of Helicobacter pylori infection before and after eradication therapy in patients younger than 45 years of age and without alarming symptoms. During our routine practice we experienced many situations in which patients with severe gastritis had no detectable Helicobacter pylori bacteria in any of two biotic samples (one from antrum and one from corpus of stomach). In order to evaluate reliability of results from histological examination we performed urea breath test as a additional procedure Material and methods: Study included 50 patients with no history of previous Helicobacter pylori infection or eradication therapy. Patients were routinely examined in endoscopic laboratory because of dyspeptic symptoms. During endoscopic examination two samples from gastric mucosa were taken- one from antrum and one from corpus. Histological examination results (classified according to Sydney system) showed severe inflammation with mononuclear and polymorphonuclear infiltration and lymphatic nodules wihout detectable Helicobacter pylori like bacteria. Many patients had signs of intestinal metaplasia also. To all of them additional urea breath test was performed and in 26/50 (52 %) results of urea breath test showed positive result. Other 24/50 (48 %) were negative on urea breath test. Conclusions: In routine clinical practice recommended procedure during endoscopic examination includes taking of minimum two biopic samples of gastric mucosa (one from antrum and corpus). In patients with severe gastritis changes without histologicaly detectable Helicobacter pylori bacteria it is recommended to perform additional urea breath test or to take more (at least 4 biopic) samples of gastric tissue during endoscopy in order to increase sensitivity of test.

Helicobacter pylori; Histology; Urea Breath Test

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