Helicobacter pylori associated dyspepsia in 208 patients from southern Saudi Arabia

Effects of the Rome IV Criteria to Functional Dyspepsia Symptoms in Saudi Arabia: Epidemiology and Clinical Practice

Background/Aims

Limited data is available in Saudi Arabia (SA) regarding the prevalence of functional dyspepsia (FD) symptoms and its subtypes, as defined by the ROME IV criteria. This study evaluated the burden of self-reported FD symptoms in the adult general population of SA and the current clinical practices.

Methods

A web-based national cross-sectional health survey of the general population of SA was conducted using the Rome IV Diagnostic Questionnaire for Functional Gastrointestinal Disorders in Adults with additional questions on the presence of symptoms compatible with functional heartburn (FH) and irritable bowel syndrome (IBS). The quality of life and somatization questionnaires were also included.

Results

Overall, 3,114 adults completed the questionnaire, but 303 (9.7%) were excluded due to inconsistent responses. Of the 2,811 consistent responders, 532 (18.3%) fulfilled the Rome IV criteria for FD symptoms. These were distributed into the FD subtypes as follows: 208 (7.4%) had postprandial distress syndrome, 228 (8.1%) had epigastric pain syndrome, and 96 (3.4%) had the overlapping variant. IBS-like symptoms were reported in 232 (44%) and FH in 102 (19%) 19% (102) of the subjects with functional dyspepsia. H. pylori-associated dyspepsia was reported by 25% (87/348). High somatization, lower quality of life scores, younger age, and female sex were associated more with the FD symptoms participants than those without. Approximately 1/5 respondents used over-the-counter medications to relieve the FD symptoms.

Conclusions

In this population-based survey, FD affected almost 1/5 of the responding adult population in SA, which was less than previously reported.

Body Mass Index and Helicobacter pylori among Obese and Non-Obese Patients in Najran, Saudi Arabia: A Case-Control Study

Objective: We examine obese and non-obese patients with respect to Helicobacter pylori (H. pylori) positive-infection (HPPI) and associated factors, specifically body mass index (BMI). Methods: This study took place in the Department of Endoscopy of a central hospital in the Najran region of Saudi Arabia (SA). A total of 340 obese Saudi patients (BMI ≥ 30 kg/m²) who had undergone diagnostic upper endoscopy before sleeve gastrectomy, were compared with 340 age and gender-matched control patients (BMI < 30 kg/m²) who had undergone diagnostic upper endoscopy for other reasons. Data collected included diagnosis of HPPI. Descriptive and multivariable binary logistic regression was conducted. Results: Mean patient age was 31.22 ± 8.10 years, and 65% were males. The total prevalence of HPPI was 58% (95% CI = 54–61%) with obese patients presenting significantly more HPPI than non-obese patients (66% vs. 50%, OR = 1.98, 95% CI = 1.45–2.70, p < 0.0005). Age and gender did not associate significantly with HPPI (p = 0.659, 0.200, respectively) and increases in BMI associated significantly with increases in HPPI (p < 0.0005). BMI remained a significant factor in HPPI when modelled with both age and gender (OR = 1.022, 95% CI = 1.01–1.03, p < 0.0005). Conclusions: Within the limitations of this study, the significance of HPPI in obese Saudi patients residing in the Najran region in SA was demonstrated alongside the significance role of BMI in HPPI.

Helicobacter pylori infection: seroprevalence and predictors among healthy individuals in Al Madinah, Saudi Arabia

BACKGROUND

Helicobacter pylori infection is one of the most common chronic bacterial infections among humans worldwide. However, there is no information on the epidemiology of H. pylori infection in Al Madinah, Saudi Arabia.

OBJECTIVE

This study was conducted to determine the seroprevalence of H. pylori in asymptomatic healthy individuals and the possible relationship between H. pylori infection and sociodemographic, lifestyle, and environmental factors in this region.

METHODS

A hospital-based cross-sectional study was conducted on a consecutive sample of asymptomatic healthy individuals. A pilot-tested interview format was used as the research tool. Venous blood was collected from individuals and sera were separated. The enzyme-linked immunosorbent assay was used to determine H. pylori IgG antibody levels in all serum samples.

RESULTS

A total of 456 samples were collected. H. pylori antibodies were found in 129 (28.3%) individuals. Seroprevalence of 16.9% was found in individuals younger than 20 years of age, which gradually increased with age and reached 36.8% by the age of 50. After controlling for the confounding factors, significant independent predictors of seropositive state were: rural residence [odds ratio (OR)=2.5, 95% confidence interval (CI)=1.3, 4.7], crowded housing (OR=1.6, 95% CI=1.1, 2.6), low socioeconomic status (OR=3.3, 95% CI=1.6, 8.8), using tanks for drinking water supply (OR=2.2, 95% CI=1.2, 7.4), active smoking (OR=5.6, 95% CI=3.2, 9.8), alcohol drinking (OR=2.3, 95% CI=1.5, 6.2), eating raw vegetables (OR=3.2, 95% CI=1.4, 7.1), eating spicy food (OR=2.1, 95% CI=1.3, 3.5), and presence of asthmatic/atopic symptoms (OR=2.5, 95% CI=1.3, 5.9). No associations were found between infection and age, gender, source of sewage disposal, eating fruits, or family history of upper gastrointestinal symptoms.

CONCLUSION AND RECOMMENDATIONS

Infection with H. pylori is declining among healthy individuals of Al Madinah, Saudi Arabia. Infection is acquired at an early age and reaches up to 36.9% as age advances. The risk of H. pylori seropositivity was related to socioeconomic, lifestyle, and environmental factors. A nationwide epidemiological study is warranted to determine the seroprevalence of H. pylori in Saudi Arabia.

Helicobacter pylori infection and its relationship to metabolic syndrome: is it a myth or fact?

Metabolic syndrome is one of the most prevalent global health problems that predisposes to Type 2 diabetes. It is strongly linked to insulin resistance, which results in hyperglycemia. Over the past few years, lot of studies have been carried out on Helicobacter pylori infection and found a possible causal relationship through releasing some of the interleukins factors, which result in endothelial dysfunction. However, some studies attributed that due to coincidence were not able to establish any causal relationship. In this review, the literature has been reviewed to check this possible association.

Prevalence of Helicobacter pylori infection in a group of morbidly obese Saudi patients undergoing bariatric surgery: a preliminary report

BACKGROUND/AIM

Earlier reports from Saudi Arabia have shown high prevalence of Helicobacter pylori infection. However, recent studies have documented a reduction in the infection prevalence. No prior study has assessed the prevalence in morbidly obese Saudi patients. We aimed to study the prevalence of H. pylori infection in a group morbidly obese Saudi patients referred for endoscopy prior to bariatric surgery.

MATERIALS AND METHODS

We retrospectively reviewed the medical records of all patients who were referred for upper endoscopy prior to bariatric surgery from June 2006 to September 2008. All data were recorded including patient's demographics, comorbid conditions, endoscopic and histological findings.

RESULTS

There were 62 patients included, 20 males and 42 females. The mean age was 34 years (range 18-51) with a mean BMI of 55 Kg/m 2 (range 35-92). H. pylori were present in 53 patients (85.5%) with chronic active gastritis. All patients with positive H. pylori had chronic gastritis of variable severity. Intestinal metaplasia was present in 5%. The prevalence of H. pylori infection was similar in patients with and without co-morbid conditions. Main endoscopic findings were gastritis in 67.7%, hiatus hernia in 13%, and gastric erosions in 13%. No patient had duodenal or gastric ulcer.

CONCLUSIONS

There is a high prevalence of H. pylori infection in morbidly obese Saudi patients undergoing bariatric surgery being referred for upper GI endoscopy. Further prospective studies are needed to evaluate the clinical implication and benefit of eradication treatment of infection in these patients.

The changing pattern of upper gastro-intestinal lesions in southern Saudi Arabia: an endoscopic study

BACKGROUND/AIM

Dyspepsia is a common gastrointestinal disorder and is the most common indication for upper gastrointestinal endoscopy (UGIE). In recent years, it has been observed in several centers that there is a change in the causes of dyspepsia as revealed by UGIE. Our main objectives were: (1) To study the pattern of upper gastrointestinal pathology in patients with dyspepsia undergoing upper endoscopy; (2) Compare that with the pattern seen 10-15 years earlier in different areas of KSA.

MATERIALS AND METHODS

Retrospective study of all UGI endoscopies performed at Aseer Central Hospital, Abha, Southern Saudi Arabia during the years 2005-2007 on patients above 13 years of age. Patients who underwent UGIE for reasons other than dyspepsia were excluded. The analysis was performed using the SPSS 14 statistical package.

RESULTS

A total of 1,607 patients underwent UGI endoscopy during the three-year study period (age range, 15-100). There were 907 males (56.4%) and 700 female (43.6%). Normal findings were reported on 215 patients (14%) and the majority had gastritis (676 = 42%), of whom 344 had gastritis with ulcer disease. Moreover, 242 patients (15%) had gastro-esophageal reflux (GERD), with or without esophagitis or hiatus hernia. Also, a total of 243 patients had duodenal ulcer (DU) (15%) while only 12 had gastric ulcer (0.7%).

DISCUSSION AND CONCLUSION

There is clear change in the frequency of UGIE lesions detected recently compared to a decade ago with an increasing prevalence of reflux esophagitis and hiatus hernia. This could be attributed to changes in lifestyle and dietary habits such as more consumption of fat and fast food, increased prevalence of obesity, and smoking. These problems should be addressed in order to minimize the serious complications of esophageal diseases.

An age- and gender-specific analysis of H. Pylori infection

The objective of this study was to determine the incidence of Helicobacter pylori infection in different age and sex groups from the southern region of Saudi Arabia, and to relate the results to the high incidence of gastric cancer in this region. The carcinogenic effect of H. pylori is considered to be age-dependent. H. pylori infection early in life predisposes patients to gastric cancer. In contrast, acquisition of infection later in life leads to development of duodenal ulcer. We studied 528 consecutive endoscopic biopsies over a period from March 1995 to August 1996. The presence or absence of H. pylori was tabulated according to age and sex of the patients. Three hundred and fifty-three (67%) of 528 patients were positive for H. pylori. There were 313 males, among whom 217 (69%) were positive. There were 215 females, among whom 136 (63%) were positive for H. pylori. The presence of H. pylori in various age groups was as follows: under 16 years, 62%; 16 to 25 years, 67%; 26-35 years, 69%; 36-45 years, 67%; 46-55 years, 66%; and 56 years and above, 65%. Statistical analysis revealed no significant difference between the groups. No significant rise in the infection rate was noted from childhood to advanced age. These data support the belief that H. pylori infection was acquired early in life, leading to multifocal gastritis and thus predisposing the patients to gastric cancer later in life. However, H. pylori may not be the single agent of gastric cancer inasmuch as the infection affects both genders equally, whereas gastric cancer has a male preference. Perhaps some additional factors augment the pivotal role of H. pylori.