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O'Connor HJ. Forty years of Helicobacter pylori infection and changes in findings at esophagogastroduodenoscopy. Helicobacter 2023; 28:e13026. [PMID: 37818739 DOI: 10.1111/hel.13026] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 09/24/2023] [Accepted: 09/26/2023] [Indexed: 10/13/2023]
Abstract
BACKGROUND It is 40 years since the discovery of Helicobacter pylori infection. Over that time major changes have occurred in esophagogastroduodenoscopy (EGD) findings. The aim of this review is to describe these changes, and the important role H. pylori infection has played in their evolution. METHODS References were identified through searches of PubMed using the search terms-endoscopy time trends, peptic ulcer disease, gastroesophageal reflux disease, upper gastrointestinal cancer, gastric polyps, H. pylori, eosinophilic gastrointestinal disorders, and celiac disease, from 1970 through December 2021. RESULTS The prevalence of H. pylori infection has fallen and consequently, H. pylori-positive peptic ulcer disease has become rare. Gastroesophageal reflux disease is now the commonest disorder diagnosed at EGD, and Barrett's esophagus has increased in parallel. Cancer of the distal stomach has fallen while esophageal adenocarcinoma and reflux-related cardia cancer have risen. Gastric polyps have changed from hyperplastic and adenomas to sporadic fundic gland polyps. Antimicrobial resistance has made H. pylori infection more difficult to eradicate. Eosinophilic gastrointestinal disorders, particularly eosinophilic esophagitis, have emerged as important new allergic disorders. Celiac disease has changed and increased. CONCLUSIONS EGD findings appear to have changed from features suggesting a H. pylori-positive "phenotype" 40 years ago to a H. pylori-negative "phenotype" today. These changes have major implications for the management of gastrointestinal disorders.
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Affiliation(s)
- Humphrey J O'Connor
- Trinity Academic Gastroenterology Group, Trinity Centre for Health Sciences, The University of Dublin, Tallaght University Hospital, Dublin, Ireland
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Yu X, Wang Z, Wang L, Meng X, Zhou C, Xin Y, Sun W, Dong Q. Gastric hyperplastic polyps inversely associated with current Helicobacter pylori infection. Exp Ther Med 2020; 19:3143-3149. [PMID: 32256802 DOI: 10.3892/etm.2020.8567] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 01/30/2020] [Indexed: 12/26/2022] Open
Abstract
The incidence of gastric hyperplastic polyps (HPs) has been on the rise in recent years. The contribution of Helicobacter pylori infection to this trend has remained to be elucidated. The present study aimed to explore the association between HPs and H. pylori in China, an area with a high infection rate of H. pylori. In order to study trends of HPs and H. pylori infection over the past decades, cases encountered from 2009 to 2018 were assessed and a total of 109,150 consecutive patients who underwent esophagogastroduodenoscopy at Qingdao Municipal Hospital (Qingdao, China) were enrolled. The incidence of HPs and the prevalence of H. pylori were determined and their correlation was explored. Gastric HPs were detected in 1,497 patients (1.6%) who received gastric biopsies. The incidence of HPs exhibited a rising trend, with a ~4-fold increase in the annual detection rate from 2009 to 2018. The prevalence of H. pylori infection was inversely associated with the prevalence of HPs (adjusted odds ratio, 0.66). The prevalence of H. pylori in the examined cohort decreased with time (r=-0.76, P=0.011). The decreasing trend of H. pylori infection was negatively correlated with the rising trend of HPs (r=-0.64, P=0.048), further indicating an inverse association between them. The difference in the prevalence of HPs between H. pylori-negative and -positive patients increased with age (r=0.80, P=0.018). The age-associated increase was slower in H. pylori-infected patients. The decline in H. pylori infection with time appeared to not be associated with the birth cohort effect, suggesting the decline was not caused by exposure to environmental factors during an early period of life. The present results indicated that the incidence of gastric HPs increased with the decline in H. pylori infection, demonstrating an inverse association between the occurrence of HPs and the infection.
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Affiliation(s)
- XinJuan Yu
- Central Laboratories, Qingdao Municipal Hospital, Qingdao University, Qingdao, Shandong 266000, P.R. China
| | - ZhengQiang Wang
- Clinical Laboratory, Qingdao Municipal Hospital, Qingdao University, Qingdao, Shandong 266000, P.R. China
| | - LiLi Wang
- Central Laboratories, Qingdao Municipal Hospital, Qingdao University, Qingdao, Shandong 266000, P.R. China
| | - XinYing Meng
- Department of Health Care, Qingdao Municipal Hospital, Qingdao University, Qingdao, Shandong 266000, P.R. China
| | - ChangHong Zhou
- Department of Health Care, Qingdao Municipal Hospital, Qingdao University, Qingdao, Shandong 266000, P.R. China
| | - YongNing Xin
- Department of Gastroenterology, Qingdao Municipal Hospital, Qingdao University, Qingdao, Shandong 266000, P.R. China
| | - WeiLi Sun
- Central Laboratories, Qingdao Municipal Hospital, Qingdao University, Qingdao, Shandong 266000, P.R. China.,Department of Gastroenterology, Qingdao Municipal Hospital, Qingdao University, Qingdao, Shandong 266000, P.R. China
| | - QuanJiang Dong
- Central Laboratories, Qingdao Municipal Hospital, Qingdao University, Qingdao, Shandong 266000, P.R. China.,Department of Gastroenterology, Qingdao Municipal Hospital, Qingdao University, Qingdao, Shandong 266000, P.R. China
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Velazquez-Dohorn M, López-Durand C, Candanedo-González F, Araujo-Villalvazo E, Gamboa-Domínguez A. Case-control analysis of fundic gland polyps and proton-pump inhibitors. A pathologist's perspective. REVISTA DE GASTROENTEROLOGÍA DE MÉXICO (ENGLISH EDITION) 2020. [DOI: 10.1016/j.rgmxen.2019.02.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
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Case-control analysis of fundic gland polyps and proton-pump inhibitors. A pathologist's perspective. REVISTA DE GASTROENTEROLOGÍA DE MÉXICO 2019; 85:42-47. [PMID: 31126726 DOI: 10.1016/j.rgmx.2019.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 02/06/2019] [Accepted: 02/06/2019] [Indexed: 11/20/2022]
Abstract
INTRODUCTION AND AIM Adequately preserved slides and tissue blocks in pathology archives, when re-reviewed and associated with patient charts, are important tools to further assess prevalence changes and associations of certain pathologies. Our aim was to identify whether proton-pump inhibitor (PPI) use, dose, and duration of use were associated with gastric polyps and their phenotypes in a case-control study. METHODS The slides from patients with a morphologic diagnosis of either hyperplastic polyps or fundic gland polyps were retrieved from the 1980, 1990, 2000, 2010, and 2016 surgical pathology files at a tertiary care hospital in Mexico City and re-evaluated. Cases were paired by age and sex with patients that underwent endoscopy and gastric mucosa biopsy in the same year, with no evidence of polyps. RESULTS A total of 133 (3.8%) patients with gastric polyps were identified from 3,499 gastric biopsies taken in the abovementioned years and compared with 133 paired controls. Dyspepsia was more prevalent in the controls (p=0.002) and abdominal pain was more prevalent in the patients with gastric polyps (p=0.001). PPI use (OR 7.7, 95% confidence interval, 4.4-13.3) and taking more than one PPI medication (OR 4.9, 95% confidence interval, 1.09-22.3) were significantly associated with the presence of gastric polyps. The fundic gland phenotype in the oxyntic mucosa was more frequently associated with PPI use (p<0.042), with a continuous increase in its prevalence starting in the year 2000 (p=0.017 for trend). CONCLUSION PPI administration for at least one year was associated with gastric fundic gland polyps.
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Kumar KR, Iqbal R, Coss E, Park C, Cryer B, Genta RM. Helicobacter gastritis induces changes in the oxyntic mucosa indistinguishable from the effects of proton pump inhibitors. Hum Pathol 2013; 44:2706-10. [DOI: 10.1016/j.humpath.2013.07.015] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2013] [Revised: 07/08/2013] [Accepted: 07/10/2013] [Indexed: 01/19/2023]
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