Treatment of Helicobacter pylori associated gastrointestinal disorder

Kwak, Inho

Abstract

BACKGROUND: Helicobacter pylori a worldwide infection in which over 50% of the general population is estimated to be affected. The association of Helicobacter pylori infection with various gastrointestinal disorders is well known. Many dyspeptic patients infected with H. pylori can be treated in primary care. One of the non-invasive means of detecting H. pylori is serology IgG antibody test (GAP). The aim of this study was to investigate the association between the serologic H. pylori IgG antibody response to antibiotic regimen in patients infected with H. pylori.
METHODS
A total of 44 patients (21 males, 23 females) who underwent health screening in a university hospital during the period from May 1996 to July 1998 and diagnosed positive by H. pylori serologic IgG antibody test and confirmed to have H. pylori infection on biopsy from endoscope procedure were selected. All the patients had dyspeptic symptoms and were diagnosed as having chronic superficial gastritis on endoscopy. Serological determination of the IgG antibodies against H. pylori was carried out before starting treatment for H. pylori eradication and 6 month after treatment.
RESULTS
The number of patients was 44 with 21 (47.7%) males and 23 (52.3%) females. In both males and females. Among those with positive H. pylori antibody who were treated with antimicrobial therapy the rate of seroconversion to negative was 28.6% in males and 39.1% in females. Those who were checked positive for H. pylori antibody and were shown to be still positive but with lower titers after eradication therapy was 57.1% for males and 47.8% for females. Those with positive H. pylori antibody who had shown seroconversion or decreased antibody titers after antimicrobial therapy were 85.7% for males and 86.9% for females. The number of subjects who failed to result in seroconversion or conversely had increased titers for H. pylori antibody after antimicrobial therapy was 14.3% for males and 13.1% for females. Overall, among those treated with BMT regimen, 11 out of 28 (39.3%) seroconverted and 12 out of 28 (42.9%) resulted in lower antibody titers. Among those treated with BMA regimen, 4 out of 16 (25.0%) seroconverted and 11 out of 16 (68.8%) resulted in lower antibody titers. Failure rates of BMT and BMA regimens were 5 out of 28 (17.8%) and 1 out of 16 (6.2%), respectively.
CONCLUSION
Based on above results, antimicrobial therapy of patients infected with H. pylori clearely indicate improvement of serologic IgG antibody resulting in seroconversion and/or decrease in titers with high rates. More accurate results may be obtained if the follow-up period is extended with the use of more reliable non-invasive techniques to detect H. pylori infection before and after treatment.