engleski

The decline in prevalence of H. pylori infection in Croatia affect significantly the incidence of ezofago-gastro-duodenal (EGD) endoscopic findings

Aim: we compare incidence of H.pylori infection and various endoscopic findings in two time periods of five years (Period-1 1994-1998 ; Period-2 2006-2010) in patients undergoing first endoscopy for dyspepsia, naive to any H.pylori treatment. Methods: From 18147 of all patients in Period-1, 1647 were untreated and examined for the first time. The same number in Period-2 was 1224 from 18529 patients. For the evaluation of H.pylori infection, 1-2 biopsy specimens were obtained from the antrum and corpus. Results: The proportion of naive patients in Period-2 was lower for 25, 7% (p<0, 0001), as well as number of both ulcers/scars: ventricular (VU) for 40, 8% and duodenal (DU) for 50.8%, (p<, 0001). Difference was not significant for stomach cancers and MALT lymphoma. Number of patients with normal gastroduodenal findings(NUD) and usually GERD symptoms showed clear increase of 65, 1%, (p<, 0001). Incidence of H. pylori infection declined significantly ; altogether from 76, 9% to 38, 7% and in all groups ; in VU from 80, 1% to 37, 1%, in DU from 85, 0% to 43, 2%, in NUD from 61, 2% to 39, 0%, even in C from 45, 7% to 37, 1% and in MALT from 100% to 80%. Conclusions: The incidence of H. pylori infection among patients undergoing EGD for dyspepsia, naive to anti-H.pylori treatment, has decreased markedly in the 15-year follow-up in Croatia. This, and earlier proton pump inhibitor use, may contribute to significant decline in incidence of peptic ulcers and maybe the decline in the prevalence of gastric cancer in the future. As we expected from West World experiance, the incidence of NUD/GERD showed clear increase.

H. pylori; prevalence; endoscopic findings

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