Abouda, G.F.; Cotton, J.C.; Dillon, J.F.
April 2003
Gut;Apr2003 Supplement 1, Vol. 52, pA41
Academic Journal
Background: Helicobacter pylori (Hp) is a microaerophilic spiral rod, which is associated with gastritis, duodenitis and gastric carcinoma. Its role in GORD is unclear, recent studies have suggested a protective role of a virulent strain against the development of GORD. Aim of work: To evaluate the prevalence of this virulence factor in patients with oesophagitis and Barrett's oesophagus. Method: 67 patients with reflux oesopahgitis, 60 patients with Barrett's oesophagus, and 25 non reflux patients (control group) underwent upper Gff endoscopy. 4 biopsies were taken from each patient, 2 from the oesophagus, 1 from the body of the stomach, and 1 from the antrum. Cio test, ELISA for Hp IgG, Western Blot for Cag, Vac, and HSP 60 of Hp, and histopathological grading of the severity, was performed on each patient. Results: 21 (31.3%) of reflux patients were CLO positive, 18(30%) of Barrett's patients were Cio positive, and 5 (20%) of the control group were CLO positive. The Cag and Vac strain was +ve in 22 patients with reflux and 15 patients with Barrett's. HSP 60 was +ve in 25 (37%) patients with reflux oesophagitis and 19 patients with Barrett's. 4 patients exhibited high grade dysplasia, and were negative for all strains except HSP60. IgG ELISA was positive in 35 (52.2%) of the patients with reflux and in 23(38%) of the Barrett's patients. The non reflux group (control group) were all Cag, Vac, and HSP 60 negative. When combining the histological grading and serological tests, patients were divided into active, past or never, according to their status of Hp infection. 22 of the GORD group and 18 of Barrett's patients were actively infected, of which 87% of GORD patients and 57% of Barrett's patients were positive for Cag, Vac, and HSP60. Conclusion: 70% of patients presenting with symptoms of reflux or Barrett's are Hp negative, of those 34% had a history of previous eradication treatment. 80% of control patients were Hp negative. In the Hp positive group, the...


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