The Diagnostic Value of Helicobacter Pylori Tests and Endoscopy for Peptic Ulcer Patients

Original article


Abdulbassit Alshalwi , Mohamed Algabsi, Salah Habil

Department of Surgery, Faculty of Medicine, Omar Almukhtar University, Derna, Libya

JMJ Vol.8, No.1 (Spring) 2008:35-38


Background: Guidelines for management of peptic ulcer patients after initial treatment are largely directed to detection of H. pylori infection using non-invasive tests. Methods: 2600 patients with dyspeptic complaints were referred for gastroscopy. The endoscopic and histological findings were evaluated according to the Sydney classification. Stool Antigen test, and ELISA investigations were performed. Results: Out of 2600 patients, (1300) representing 50% had positive endoscopic findings. From these patients, 533 patients (41%) showed peptic ulcer ,403 were duodenal and 130 were gastric. 357 (67%) were males and 176 (33%) were female, with a male: female ratio 2:1. Out of 533 patient with peptic ulcer by endoscopy, 451 (84.6%) had positive endoscopic for H pylori. The prevalence of H pylori infection was 66% in Stool Antigen test and 62% in ELISA test. The healing rate in anti H pylori treated group was significantly higher than the non treated group (95% and 75 %, respectively) (X2 = 15.7, P< 0.001). The recurrence rate 5 years was significantly lower than the untreated group (31% and 73%, respectively) (X2 = 35.3 P< 0.001). Conclusions: Patients with dyspepsia should not be monitored only by non-invasive investigation methods (ELISA and stool antigen test as they have shown good concordance); it is also justified to use the classical histological evaluation of H. pylori colonization, Moreover, endoscopy and histological investigation of a gastric biopsy have proved to be methods with additional diagnostic value, providing the physician with information about inflammatory, atrophic and metaplastic lesions of the stomach in dyspeptic H. pylori positive and negative patients. Keywords: Peptic ulcer, H. pylori, Non-invasive, Endoscopy, Diagnostic value Link/DOI: