[Helicobacter pylori eradication frequency with the conventional triple therapy in adult patients at the Centro Médico Issemym]

BACKGROUND

In Mexico, the prevalence of Helicobacter pylori (H. pylori) infection is high. The bacterial eradication rate with the administration of antibiotic regimens recommended by international guidelines is not yet clear.

AIMS

To determine the eradication frequency of H. pylori infection in the adult Mexican population that underwent treatment with the conventional triple regimen.

MATERIAL AND METHODS

A cross-sectional study was carried out that evaluated the effectiveness of the triple regimen in individuals with confirmed infection that received consensual treatment and then underwent tests to corroborate eradication.

RESULTS

From a total of 249 potential case records, 26 did not meet the inclusion criteria. Two hundred and twenty-three patients were enrolled for analysis, 64,00% women and 36,00% men, with a mean age of 49,4 years (range 17-86). Comorbidities presented in 55,60% of the patients and 28,60% referred to chronic use of nonsteroidal anti-inflammatory drugs (NSAIDs). Bacterial eradication with the triple regimen was 65,50% (146/223); of the 77 patients with no eradication, 11 received a quadruple regimen as second-line treatment resulting in bacterial eradication in 5/11 (45,45%) patients, for an overall eradication of 67,70%.

CONCLUSIONS

The eradication rate in our study population was suboptimal due to the probability of multiple factors that are difficult to identify, given the retrospective design of the study. A prospective and controlled evaluation of the recommended regimens needs to be carried out in order to determine their true effectiveness.

[Primary sclerosing cholangitis of small ducts, associated with eosinophilic gastroenteritis. Case report and literature review.]

Primary sclerosing cholangitis (PSC) is a chronic cholestatic liver disease of unknown etiology, probably immune-mediated. PSC is frequently associated with Inflammatory Bowel Disease, usually Ulcerative Colitis and less commonly with Crohn's disease. The small-duct PSC variant occurs in 5%of patients. Eosinophilic gastroenteritis (EG) is another chronic inflammatory disease, characterized by eosinophilic infiltration limited to the digestive tract, and probably of immunoallergic origin. EG is frequently observed in children but it's less commonly seen in adults. EG can affect any segment of the gastrointestinal tract, and recently it has been described an increase in the incidence of the esophagic variant, termed eosinophilic esophagitis.Ileocolonic involvement in EG is rare and clinical manifestations depend of the intestinal layer affected. Patients with mucosal infiltration complain of abdominal pain, fecal occult blood loss and/or protein-losing enteropaty, while signs and symptoms of obstruction are common in those with muscular EG, finally involvement of the serosal layer occurs in 10% and typically presents as eosinophil-rich ascitis. Response to steroids usually is excellent. There is a previous publication in the literature documenting the association of PSC and EG. Here we describe the first case of small-duct PSC associated to EG with ileocolonic involvement.