gastritis

Helicobacter pylori (H. pylori) infection, a common organic cause of dyspepsia, often lacks macroscopic mucosal lesions, necessitating distinction from functional dyspepsia. This study assessed H. pylori prevalence, optimal biopsy sites, histopathological changes, and infection density in dyspeptic patients.

Gastric mucosal biopsies from 100 dyspeptic patients were formalin-fixed, paraffin-embedded, and sectioned (5μm). Hematoxylin and eosin (H&E) and Giemsa stains were used for histopathological evaluation, with Giemsa specifically applied for H. pylori grading.

Patients (mean age: 44.37 years; range: 11–80) showed peak H. pylori prevalence in the fourth (28%, n=28) and fifth (29%, n=29) decades, with a male-to-female ratio of 1.26:1. Common symptoms included nausea (76%, n=76), epigastric discomfort, abdominal pain, and bloating. Chronic gastritis was identified in 89% (n=89), with 82% (n=82) testing H. pylori-positive, all exhibiting chronic active gastritis. The pyloric antrum was the predominant colonization site (86.58%, n=71/82), followed by the fundus (84.14%, n=69/82) and body (74.39%, n=61/82). Per the Sydney System, inflammation severity was mild (42.68%, n=35), moderate (48.78%, n=40), or severe (8.54%, n=7). H. pylori density was graded as mild (36.59%, n=30), moderate (54.88%, n=45), or dense (8.53%, n=7).

Early H. pylori detection and eradication alleviate symptoms and prevent complications. Giemsa stain proved optimal for H. pylori identification due to its cost-effectiveness and rapidity. The pyloric antrum, followed by the fundus and body, is the primary biopsy site for diagnosing H. pylori-associated gastritis. These findings emphasize targeted biopsy protocols and efficient diagnostic methods in managing dyspepsia.

Helicobacter pylori is a gram-negative pathogen. The infection caused by this pathogen may result in gastritis and can increase the risk of gastric cancer. This study investigated the relationship between H. pylori infection as the main risk factor for gastritis and changes in serum inflammatory cytokine levels.

Blood samples from 85 patients with stomach pain, including 46 H. pylori-positive (Hp+) and 39 H. pylori-negative (Hp- ) cases, were collected and referred to a gastroenterologist. After isolation and identification of H. pylori, the severity of gastritis was determined for each patient based on the histopathological findings. Finally, the serum levels of cytokines were measured using the multiplex kit and flow cytometry methods.

There were significant differences in the levels of interleukin-2 (IL-2), IL-4, IL-17A, IL-17F, IL-22, tumor necrosis factoralpha (TNF-α), and interferon-gamma (IFN-γ) between the Hp- and the Hp+specimens (P≤0.05). The levels of IL-2, IL-17A, IL-17F, IL-22, TNF-α, and IFN-γ were significantly higher in patients with mild and moderate gastritis than Hp- group (P≤0.05). In addition, IL-4 significantly increased in patients with moderate gastritis compared with Hp- individuals (P=0.008).

Among the inflammatory cytokines evaluated in this study, IL-17A, IL-17F, and IL-22 may play a crucial role in developing moderate gastritis in infected patients with H. pylori.

Antibiotic resistance and adverse effects pose significant challenges to the effectiveness of Helicobacter pylori eradication therapies, such as clarithromycin-based triple therapy. Alternative treatments, including bismuth quadruple therapy, are effective in cases of clarithromycin resistance. Levofloxacin and metronidazole-based triple therapy have demonstrated high success rates with fewer side effects, making it a preferred option following clarithromycin treatment failure.

This study aimed to evaluate the effectiveness of levofloxacin and metronidazole in eradicating H. pylori among patients with chronic epigastric pain in Zakho, Iraq. It also assessed the accuracy of diagnostic tests, patient history, and post-treatment confirmation of eradication.

A prospective study was conducted involving 100 patients with chronic epigastric pain at Zakho General Teaching Hospital. Diagnosis was performed using the fecal antigen test, urea breath test (UBT), and endoscopy with biopsy. Patients were treated with a 14-day regimen comprising levofloxacin, metronidazole, and either esomeprazole or pantoprazole.

Of the 100 participants, 66% were female, with a mean age of 37.85 years. The fecal antigen test, performed on 60 patients, showed a positivity rate of 96.5%, while the UBT, conducted on 40 patients, revealed a positivity rate of 97.5%. The highest infection rate was observed in the 51 - 60 age group. The 14-day levofloxacin and metronidazole regimen achieved a 99% eradication rate with minimal side effects.

This study underscores the high efficacy of levofloxacin and metronidazole-based therapy for H. pylori eradication. It highlights the importance of non-invasive diagnostic methods, enhanced patient follow-up, and international collaboration to achieve optimal treatment outcomes.

Intestinal infections with Helicobacter pylori mainly occur during childhood. If contracted, these infections may cause chronic gastritis, frequently leading to peptic ulcer disease in later life. This study aims to detect the prevalence of H. pylori infections in patients with active gastritis.

The study included 150 participants who were consuming daily anti-gastritis drugs to reduce the gas and were considered active gastritis patients and were recruited from Lekhnath 12, now known as Pokhara metropolitan-30, from May 2018 to March 2019. They were screened for H. pylori antibodies for detection of infection by the immunochromatographic rapid detection kit, and the data were analyzed using SPSS 2016.

Serum anti-Helicobacter pylori antibodies were used to detect the presence of Helicobacter pylori in these participants. Among the 150 participants, 54 were males (36%) and 96 were females (64%). The results showed that 47 (31.3%) of the patients were positive for anti-Helicobacter pylori test. The age group 30 to 40 had the highest prevalence of 21 (14.0%). Using public water showed the highest prevalence with a P value of 0.04.

There should be an additional aspect required for the diagnosis and treatment of gastritis, which is the healthcare providers' and patients' awareness of the cause and most efficient treatments for this medical condition. Using only anti-gastritis drugs is not sufficient; treatment against Helicobacter pylori requires the right pathway of treatment by the use of several antibiotics.

Helicobacter pylori infections vary in severity and virulence in different populations for various reasons. There are different H. pylori strains with varying degrees of virulence. The genetic diversity of H. pylori strains in gastritis patients in different areas has not been well understood. This study aimed to evaluate the prevalence rate and different genotypes of H. pylori strains in clinical specimens of patients with gastritis in Ilam, Iran.

Saliva and gastric biopsy samples were collected from 81 patients (55 males and 26 females in the age range of 20 to 90 years) referring to Ilam medical centers. After DNA extraction, the prevalence of H. pylori as well as vacA, cagA, and ureC genes was evaluated using PCR, and then each vacA-positive sample was further evaluated for m1m2 and s1s2 variants.

The cagA and vacA genes were found in 27 (71%) and 36 (94.7%) H. pylori-positive samples, respectively. The cagA gene was detected in patients with gastric pain (44.4%) and anorexia (18.51%). Also, the results showed that the vacA s2m2 genotype and m2 allele were present in 32.9% of H. pylori isolates. Moreover, s2m2 and s1m2 genotypes were detected in 42.1 and 26.3% of vacA-positive samples, respectively. The lowest frequency was related to the m1 allele (17.18%).

This study results indicate a plausible relationship between the presence of some genotypes of H. pylori and the progression of gastritis, suggesting these markers as promising biomarkers to predict the disease severity.

Fecal calprotectin (FC) is suggested as a novel biomarker for the diagnosis of gastrointestinal (GI) diseases; however, few studies have investigated its diagnostic value for Helicobacter pylori (H. pylori). Therefore, the current study evaluated the level of FC and its diagnostic value in patients with H. Pylori and its related conditions including gastritis and duodenitis.

In this case‑control study, 120 children with upper GI symptoms, who were indicated to undergo upper GI endoscopic examination, were consecutively included. Patients were categorized into different groups based on their endoscopic findings including H. pylori, gastritis, duodenitis or normal.

Patients with gastritis (P = 0.014) and those with duodenitis (P < 001) had significantly higher FC. The level of FC was higher in patients with H. pylori but this difference was marginally significant (P = 0.054). The level of FC had poor ability to diagnose the presence of H. pylori (P = 0.054) and gastritis (area under the curve, AUC = 0.639, P = 0.014). However, it had acceptable power to diagnose patients with or duodenitis (AUC = 0.718, P < 0.001). The sensitivity and specificity of FC for diagnosis of gastritis were 64 and 65 percent (cut‑off = 45.2 µg/g), and for duodenitis were 77 and 61 percent (cut‑off = 46.2 µg/g), respectively.

FC can be considered as an objective and diagnostic tool for duodenitis. However, due to the low sensitivity and specificity, it is suggested to consider it as an objective supplementary test beside other established diagnostic modalities.

Helicobacter pylori, is a major etiologic agent associated with gastritis. There is more evidence of noncoding microRNAs (miRs) dysregulation in gastrointestinal diseases, including inflammation caused by Helicobacter pylori. Also, the classification of gastrointestinal malignancies using the miRs profile is better than the protein profile. MiRNA-155(miRNA-155) among other miRs plays an important role in control of inflammation and gastric malignancy, so it can be remarkable prognosis marker of gastric cancer in the phase of chronic gastritis. The aim of this study was to compare the expression of miRNA-155 in gastric biopsy and serum samples of adult patients with chronic gastritis.

Biopsy and blood samples were collected from endoscopy candidates at Taleghani hospital, Tehran, during 2019. H. pylori infection was detected using histology, culture and molecular PCR methods. Based on cagA and vacA genotyping, the toxicity of H. pylori isolates were determined. After RNA extraction, the expression rate of miRNA-155 was evaluated by real-time polymerase chain reaction (RT-PCR) in gastric tissue and serum of adults infected by H. pylori (n = 30) compared with control group without infection (n = 20). RNU6 housekeeping miRNA were used as endogenous control and statistical analyses were performed using SPSS, ANOVA and Student’s t-test.

miRNA-155 expression in H. pylori infected adult patients increased significantly by 5.61 and 10.11 fold in serum and tissue respectively, compared to that observed in the control group. Evaluation of miRNA-155 expression pattern in relation to bacterial virulence factors showed that the increase in miRNA-155 expression is independent of CagA and VacA toxins.

According to the differential expression patterns of miRNA-155 in serum samples of the infected adult patients, miRNA-155 has the potential to evaluate as chronic gastritis marker.

Helicobacter pylori colonizes gastric tissue in obese patients and mostly remains undetected clinically, as histological and molecular analysis is seldom ordered in such cases.

This study aimed to detect the frequency of H. pylori using different techniques in sleeve gastrectomy specimens of obese patients with minimal or no symptoms suggestive of gastritis.

This longitudinal study was carried out at Farooq Hospital Westwood Lahore, Morbid Anatomy and Histopathology Department and Resource Laboratory at the University of Health Sciences, Lahore, Pakistan, from February 2021 to September 2021. This study selected 80 cases who underwent sleeve gastrectomy within six months. Helicobacter pylori was detected by rapid urease test (RUT), modified Giemsa staining, and polymerase chain reaction (PCR) techniques.

Most patients (83.7%) were clinically asymptomatic, while 10% had mild and 6.3% had moderate to severe gastritis symptoms. Of the asymptomatic patients, 56.7% of biopsies showed chronic gastritis. Rapid urease test and modified Giemsa staining showed positive evidence for H. pylori in 47.3% of cases, whereas an additional 13.2% of biopsies that were negative on conventional methods showed the amplification of H. pylori DNA by PCR. Patients were discharged with proton-pump inhibitors therapy (40 mg/day) that showed no adverse post-surgical event over a follow-up of six months.

Persistent obesity and other socioeconomic factors may lead to colonizing asymptomatic H. pylori infection. More sensitive techniques for detecting H. pylori may be employed in resource-constrained settings for better patient outcomes and to minimize the complications after sleeve gastrectomy.

The increasing prevalence of antibiotic-resistant strains of Helicobacter pylori (H. pylori) led to reduced success with traditional H. pylori treatments. This warrants further evaluation of other treatment options. One such treatment regimen of interest is nitazoxanide containing regimen. In this study, we evaluated the efficacy of the addition of nitazoxanide to clarithromycin-based triple therapy in patients with H. pylori infection.

In this single-center prospective observational trial, patients with H. pylori infection were treated with a regimen comprising of nitazoxanide 1000 mg, amoxicillin 2000 mg, clarithromycin 1000 mg, and esomeprazole 80 mg per day (NACE regimen) for14 days. Eradication of H. pylori infection was assessed 4 weeks after completion of therapy by using stool antigen assay. Treatment compliance and adverse effects were also evaluated.

Out of 111 patients who entered into the study for final analysis, H. pylori eradication was achieved in 93.7% (104 out of 111) patients in per-protocol analysis and 90.4% (104 out of 115) patients in intention to treat analysis. The treatment regimen was well tolerated.

The addition of nitazoxanide to standard clarithromycin-based triple therapy effectively eradicates H. pylori infection. This regimen is safe and well tolerated.

The worldwide prevalence of Helicobacter pylori is about 50%. This bacterium needs a number of virulence factors for pathogenesis. This study aimed to determine the prevalence of virulence genes (ureB, cytotoxin-associated gene A [cagA], and vacuolating cytotoxin [vacA]), as well as the antigenic profile in H. pylori strains.

Eighty-five patients with abdominal pain, including 46 H. pylori-positive (Hp+) and 39 H. pylori-negative (Hp-) cases, were enrolled in this study. The serum levels of interleukin (IL)-17F, tumor necrosis factor α (TNF-α), and interferon γ (IFN-γ) cytokines were measured by multiplex kits and flow cytometry. After molecular identification by the ureC gene, vacA, cagA, and ureB genes were detected by polymerase chain reaction (PCR). Finally, after antigenic extraction, the whole-cell protein was exhibited by sodium dodecyl sulphate–polyacrylamide gel electrophoresis (SDS-PAGE).

The prevalence of vacA, ureB, and cagA genes were 91.3%, 67.39%, and 50%, respectively. The frequency of genes and cell surface antigens were not significantly different based on the gastritis severity (p > 0.05). IL-17F significantly (p = 0.046) increased in the presence of 19.5 kDa (outer membrane protein [OMP]). Moreover, the OMP antigen significantly enhanced immunoglobulin A (IgA; p = 0.013). In the presence of the 66-kDa (ureB) antigen, the serum level of IFN-γ increased (p = 0.041). Finally, the CagA protein led to increased IgG antibody levels (p = 0.027).

Early detection of H. pylori infection can play a crucial role in managing it. Our results suggest that IL-17F, TNF-α, and IFN-γ cytokines could be diagnostic markers. However, further studies are required to fully investigate this suggestion.

 Stomach disorders, including gastric cancer and gastritis, are associated with the pathogenic bacterium Helicobacter pylori. Enhanced inflammation is the characteristic of H. pylori-induced gastritis. Ligustrazine exerts anti-inflammatory properties in mouse asthma models and acute kidney injury.

 To determine the role of ligustrazine in H. pylori-induced gastritis.

 Normal gastric epithelial cell line (GES-1) was cultured with H. pylori at a multiplicity of infection (MOI) of 100: 1 for 24 hours. GES-1 cell line under H. pylori condition was incubated with 100 or 200 μM ligustrazine for 24 hours. Cell viability and apoptosis were investigated by MTT and flow cytometry assays, respectively. Inflammation was assessed by determining the levels and mRNA expression of interleukins (IL)-6/8, tumor necrosis factor-α (TNF-α), and monocyte chemotactic protein 1 (MCP-1) using ELISA and qRT-PCR analysis, respectively.

 Helicobacter pylori infection reduced the viability and promoted the apoptosis of GES-1 cell line, accompanied by the enhanced activities of caspases 3 and 9. However, ligustrazine reversed the H. pylori-induced infection decreased viability, while increased apoptosis and caspases 3/9 activities in GES-1 cell line. Moreover, ligustrazine attenuated H. pylori-induced secretions of pro-inflammatory factors, IL-6/8, TNF-α, and MCP-1, in GES-1 cell line. The protein expression of inhibitor of NF-κB (IκBα) was downregulated in GES-1 cell line after H. pylori infection, while the protein expression levels of p65 and phosphorylation of IκBα were upregulated by H. pylori infection. On the contrary, ligustrazine decreased H. pylori-induced protein expression of IκBα, whereas increased protein expression of p65 and phosphorylation of IκBα.

 Ligustrazine exerted protective effects on H. pylori-induced gastric epithelial cells through inhibition of gastric inflammation and apoptosis and inactivation of NF-κB pathway.

Gastritis is one of the most current gastrointestinal disorders worldwide. Alcohol consumption is one of the major factors, which provides gastritis. Rosmarinic acid (RA) is found in many plants and has powerful antioxidant and anti-inflammatory effects. In this study, the protective effect of RA was evaluated on the histopathological indices, antioxidant ability, and prostaglandin E2 (PGE2) secretion in male rats.

Forty-two animals were divided into control, ethanol-induced gastritis, and RA groups, 6 each. The protective groups included RA administration before gastritis induction at 50 mg (R-G50), 100 mg (R-G100), 150 mg (R-G150), and 200 mg (R-G200) doses. Gastritis was induced by gavage of 1 mL pure ethanol in fasted animals. After 1 h of gastritis induction, the rats were sacrificed and stomach tissue was removed.

Histological evaluation revealed that RA significantly attenuated gastric ulcers, leucocyte infiltration, and hyperemia. It also increased mucosal layer thickness and restored gastric glands. Furthermore, RA decreased malondialdehyde level, increased superoxide dismutase, catalase, and glutathione in the stomach tissue, and raised gastric PGE2 level.

Our study demonstrated that rosmarinic acid has a notable effect on gastritis protection that could be due to increased antioxidant defense and PGE2 secretion, eventually maintenance of mucosal barrier integrity and gastric glands.

Stress has been suggested to play an important role in the pathogenesis of gastric damage by either acting as a predisposing factor or a primary factor. Arcobacter species have frequently been isolated from stomach ulcer cases of pigs, but the role of these agents in the pathogenesis of the disease remains unclear.The primary aim of the present study was, to reveal the role of Arcobacter butzleri and stress in the etiology of gastric damage by establishing an experimental mouse design. Infection was induced by intra-gastric gavage of A. butzleri in two experimental groups comprising five weeks old specific pathogen-free (SPF) Balb/c mice. At 1, 2, 3, 4, and 7th weeks of the experiment, the animals were euthanized and examined for lesions occurring in the stomach. Histopathology, culture, and Polymerase Chain Reaction (PCR) were employed to detect development and severity of lesions and pathogens. In addition, serum corticosterone levels indicating the presence of stress in the mice were investigated by an ELISA method. Microscopic examination showed that the stomach of the experimental group had inflammatory reactions to varying degrees, but ulcers were not observed in the gastric mucosa of the animals exposed to A. butzleri and stress groups. The results suggested that A. butzleri and stress were predisposing factors in the formation of gastric ulcer, but failed to provide evidence for their causative role.

 Identification of the causes of gallstone would result in better planning for the prevention of this disease. One of the proposed risk factors for this problem is Helicobacter pylori(H. pylori) infection.

 The purpose of this study was to determine the incidence rate of gallstone in patients with H. pylori gastritis.

 This was an observational study performed as a descriptive-comparative cross-sectional survey. We enrolled 169 consecutive patients with H. pylori gastritis admitted to Imam-Hossein Hospital, Tehran, Iran, in 2018, and gallstone frequency in them was determined and compared with other variables.

 Overall, 14 (8.3%) patients had gallstone, and all the patients had H. pylori gastritis. There was no significant association between gallstone and H. pylori gastritis (P = 0.561).

 It may be concluded that gallstone frequency in patients with H. pylori gastritis is low, and there is no significant association between these two conditions.

There are studies on Helicobacter pylori infection in Khyber Pakhtunkhwa. However, district Buner is far away, and most people have the least access to more developed techniques for the diagnosis of different diseases, and no study has been conducted in this region. Therefore, this study was conducted to determine the frequency of H. pylori infection in patients presenting with upper gastrointestinal symptoms.

This study aimed to determine the frequency of H. pylori antigen in the stool of patients with upper gastrointestinal symptoms.

A cross-sectional study was conducted at Bilal Medical Trust Hospital from February 2018 to November 30, 2019. A total of 111 patients presenting with upper gastrointestinal symptoms were included in this study. A purposive (non-probability) sampling technique was used. All of the patients were screened for H. Pylori in stool specimens using a specific stool H. pylori device.

Out of 111 patients, 74 (66.66%) were reported positive for H. pylori infection, among whom, females had a higher ratio (54.05%) than had males (45.94%). The infection was more prevalent in patients aged 20 - 30 years (43.67%). Patients who consumed fresh milk had higher rates of infection than those who used powdered milk/packed milk (52.54% vs. 15.25%). Patients who consumed water from water wells had a higher infection rate (72.87%) than those who used water from tube wells (27.11%).

The present study revealed a higher prevalence of H. pylori in females than in males. The maximum prevalence was noticed in the age group of 20 - 30 years. The study indicated a significantly higher rate of H. pylori infection in patients who used uncooked milk and water from contaminated sources.