The effects of Helicobacter pylori eradication therapy on salivary pepsin concentration in patients with laryngopharyngeal reflux

OBJECTIVE

To investigate the effect of Helicobacter pylori (HP) eradication therapy on salivary pepsin concentration in laryngopharyngeal reflux (LPR) patients with HP infection.

MATERIALS AND METHODS

A total of 477 patients with suspected LPR were enrolled from June 2020 to September 2021. Reflux symptom index, reflux finding score, the positive rates and disintegrations per minute values of HP infection detected by ¹⁴C urea breath test and salivary pepsin concentrations analyzed using enzyme-linked immunosorbent assay were compared in LPR patients and non-LPR patients with or without HP infection. HP-positive patients were treated with HP eradication therapy while HP-negative patients with PPI therapy.

RESULTS

The scores of nagging cough (0.88 vs. 0.50, P = 0.035), erythema or hyperemia (1.93 vs. 1.78, P = 0.035) and vocal fold edema (1.04 vs. 0.85, P = 0.025) were higher in the LPR (+) Hp (+) subgroup than in LPR (+) Hp (-) subgroup. The concentrations of salivary pepsin in the Hp (+) subgroup were higher than in the Hp (-) subgroup either in LPR patients (75.24 ng/ml vs. 61.39 ng/ml, P = 0.005) or the non-LPR patients (78.42 ng/ml vs. 48.96 ng/ml, P = 0.024). Compared to baseline (before treatment), scores of nagging cough (0.35 vs. 0.84, P = 0.019) and erythema or hyperemia (1.50 vs. 1.83, P = 0.039) and the concentrations of salivary pepsin (44.35 ng/ml vs. 74.15 ng/ml, P = 0.017) in LPR patients with HP infection decreased after HP treatment; yet, this was not observed for the LPR patients without HP infection treated with PPI only (P > 0.05).

CONCLUSION

HP infection may aggravate the symptoms and signs of LPR patients, partly by increasing their salivary pepsin concentration.

Prevalence of Helicobacter Pylori Infection in Patients with Dyspepsia in North of Iran

BACKGROUND Dyspepsia is a common complaint among patients who refer to gastroenterology clinics. Studies have shown that there is a strong relationship between dyspepsia and Helicobacter pylori (HP) infection. We have investigated the prevalence of HP infection in patients with dyspepsia and its correlation with age and socioeconomic status (SES) of patients in Mazandaran province, northern Iran. METHODS In this cross-sectional study, patients with dyspepsia who had undergone upper gastrointestinal endoscopy were enrolled. Diagnosis of HP infection was according to the results of rapid urease test (RUT), and Giemsa staining of pathology samples. A questionnaire including endoscopic findings, demographic data, and SES information was completed for each patient. RESULTS The mean age of the 614 patients was 45.8±5 years, and 60% of them were female. Most patients had normal endoscopy (56.1%), and gastric ulcer and erosion was the most common abnormal endoscopic finding (24.7%). The prevalence of HP infection in patients with dyspepsia was about 66.6%. HP infection was associated with a lower prevalence in people aged below 30 years and good SES. CONCLUSION The prevalence of HP infection in patients with dyspepsia was 66.6%. In addition, HP infection rate was lower in people under the age of 30 years and patients with good SES.

Meta-analysis of the efficacy of lansoprazole and omeprazole for the treatment of H.pylori-associated duodenal ulcer

OBJECTIVE

To conduct a systematic evaluation of the efficacy of lansoprazole and omeprazole for the treatment of Helicobacter pylori-associated duodenal ulcer.

METHODS

Online databases, including CHKD, VIP, China Info, the National Digital Library of China, Google Scholar, PubMed, Lippincott Williams & Wilkins, and Wiley Online Library were searched for related studies. The quality of the studies was evaluated in accordance with the Cochrane Handbook for Systematic Reviews of Interventions, and relevant information was extracted from them. The studies were subjected to meta-analysis using RevMan5.3 software, and qualitative analysis was performed for studies, in which the data could not be merged.

RESULTS

A total of nine randomized controlled trials (RCTs) were included, all of which presented the possibility of bias. Meta-analysis showed no significant differences between patients treated with lansoprazole combinations and omeprazole combinations in terms of DU healing rate (RR = 1.04, 95% CI = 0.99~1.09, P = 0.93). There were significant differences between those treated by lansoprazole combination and omeprazole combination in terms of HP eradication rate (RR = 1.09, 95% CI = 1.01~1.18, P = 0.04), and there was no serious adverse reaction during the treatment process for both lansoprazole and omeprazole.

CONCLUSION

Lansoprazole and omeprazole exhibit similar efficacy in the treatment of Helicobacter pylori associated duodenal ulcers.