Skip to main content
Log in

Evaluation of Helicobacter pylori status and endoscopic findings among new outpatients with dyspepsia in Japan

  • Original Article—Alimentary Tract
  • Published:
Journal of Gastroenterology Aims and scope Submit manuscript

Abstract

Purpose

The 2005 ACG guidelines for the management of dyspepsia recommend eradication and proton pump inhibitors for patients who are H. pylori-positive and-negative, respectively. To establish Japanese guidelines for dyspepsia, we evaluated H. pylori status and endoscopic findings among outpatients with dyspepsia.

Methods

The status of H. pylori in dyspeptic patients was determined by measuring urinary levels of anti-H. pylori antibody (RAPIRAN®). We then compared the endoscopic findings between H. pylori-positive and -negative patients.

Results

The prevalence of H. pylori among 258 dyspeptic patients was 47.8%, and increased with age (11.1% at age 10–19 years; >50% at age >50 years). The prevalence of H. pylori in each age-group tended to be lower among male than female dyspeptic patients. Endoscopy (n = 138) showed that H. pylori-negative patients rarely had peptic ulcers or gastric cancer, and 84.7% had no endoscopic findings, which was significantly higher when compared to H. pylori-positive patients (67.3%) (p = 0.029).

Conclusions

Over half of the dyspeptic Japanese patients examined were negative for H. pylori. Patients who are H. pylori-positive should undergo endoscopy to rule out gastric malignancy, peptic ulcers and other diseases.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Marshall B, Warren J. Unidentified curved bacilli in the stomach of patients with gastritis and peptic ulceration. Lancet. 1984;1(8390):1311–5.

    Article  PubMed  CAS  Google Scholar 

  2. NIH Consensus Conference. Helicobacter pylori in peptic ulcer disease. NIH Consensus Development Panel on Helicobacter pylori in peptic ulcer disease. JAMA. 1994;272(1):65–9.

    Article  Google Scholar 

  3. Uemura N, Okamoto S, Yamamoto S, Matsumura N, Yamaguchi S, Yamakido M, et al. Helicobacter pylori infection and the development of gastric cancer. N Engl J Med. 2001;345(11):784–9.

    Article  PubMed  CAS  Google Scholar 

  4. Wotherspoon A, Ortiz-Hidalgo C, Falzon M, Isaacson P. Helicobacter pylori-associated gastritis and primary B-cell gastric lymphoma. Lancet. 1991;338(8776):1175–6.

    Article  PubMed  CAS  Google Scholar 

  5. Graham D, Lew G, Klein P, Evans D, Evans DJ, Saeed Z, et al. Effect of treatment of Helicobacter pylori infection on the long-term recurrence of gastric or duodenal ulcer. A randomized, controlled study. Ann Intern Med. 1992;116(9):705–8.

    PubMed  CAS  Google Scholar 

  6. Wotherspoon A, Doglioni C, Diss T, Pan L, Moschini A, de Boni M, et al. Regression of primary low-grade B-cell gastric lymphoma of mucosa-associated lymphoid tissue type after eradication of Helicobacter pylori. Lancet. 1993;342(8871):575–7.

    Article  PubMed  CAS  Google Scholar 

  7. Uemura N, Mukai T, Okamoto S, Yamaguchi S, Mashiba H, Taniyama K, et al. Effect of Helicobacter pylori eradication on subsequent development of cancer after endoscopic resection of early gastric cancer. Cancer Epidemiol Biomarkers Prev. 1997;6(8):639–42.

    PubMed  CAS  Google Scholar 

  8. Mégraud F, Brassens-Rabbé M, Denis F, Belbouri A, Hoa D. Seroepidemiology of Campylobacter pylori infection in various populations. J Clin Microbiol. 1989;27(8):1870–3.

    PubMed  Google Scholar 

  9. Asaka M, Kimura T, Kudo M, Takeda H, Mitani S, Miyazaki T, et al. Relationship of Helicobacter pylori to serum pepsinogens in an asymptomatic Japanese population. Gastroenterology. 1992;102(3):760–6.

    PubMed  CAS  Google Scholar 

  10. Shimatani T, Inoue M, Iwamoto K, Hyogo H, Yokozaki M, Saeki T, et al. Prevalence of Helicobacter pylori infection, endoscopic gastric findings and dyspeptic symptoms among a young Japanese population born in the 1970s. J Gastroenterol Hepatol. 2005;20(9):1352–7.

    Article  PubMed  Google Scholar 

  11. Rosenstock S, Kay L, Rosenstock C, Andersen L, Bonnevie O, Jørgensen T. Relation between Helicobacter pylori infection and gastrointestinal symptoms and syndromes. Gut. 1997;41(2):169–76.

    Article  PubMed  CAS  Google Scholar 

  12. Talley N, Vakil N. Guidelines for the management of dyspepsia. Am J Gastroenterol. 2005;100(10):2324–37.

    Article  PubMed  Google Scholar 

  13. Graham D, Reddy S. Rapid detection of anti-Helicobacter pylori IgG in urine using immunochromatography. Aliment Pharmacol Ther. 2001;15(5):699–702.

    Article  PubMed  CAS  Google Scholar 

  14. Talley N, Zinsmeister A, Schleck C, Melton Lr. Dyspepsia and dyspepsia subgroups: a population-based study. Gastroenterology. 1992;102(4 Pt 1):1259–68.

    PubMed  CAS  Google Scholar 

  15. Mearin F, de Ribot X, Balboa A, Salas A, Varas M, Cucala M, et al. Does Helicobacter pylori infection increase gastric sensitivity in functional dyspepsia? Gut. 1995;37(1):47–51.

    Article  PubMed  CAS  Google Scholar 

  16. Armstrong D. Helicobacter pylori infection and dyspepsia. Scand J Gastroenterol Suppl. 1996;215:38–47.

    Article  PubMed  CAS  Google Scholar 

  17. Pfaffenbach B, Adamek R, Bartholomäus C, Wegener M. Gastric dysrhythmias and delayed gastric emptying in patients with functional dyspepsia. Dig Dis Sci. 1997;42(10):2094–9.

    Article  PubMed  CAS  Google Scholar 

  18. Sasaki N. Endoscopic diagnosis of gastritis in relation to Helicobacter pylori infection and subjective symptoms. J Clin Gastroenterol. 1995;21:S135–9.

    Google Scholar 

  19. Kawamura A, Adachi K, Takashima T, Murao M, Katsube T, Yuki M, et al. Prevalence of functional dyspepsia and its relationship with Helicobacter pylori infection in a Japanese population. J Gastroenterol Hepatol. 2001;16(4):384–8.

    Article  PubMed  CAS  Google Scholar 

  20. Woodward M, Morrison C, McColl K. The prevalence of dyspepsia and use of antisecretory medication in North Glasgow: role of Helicobacter pylori versus lifestyle factors. Aliment Pharmacol Ther. 1999;13(11):1505–9.

    Article  PubMed  CAS  Google Scholar 

  21. Wildner-Christensen M, Hansen J, De Muckadell O. Risk factors for dyspepsia in a general population: non-steroidal anti-inflammatory drugs, cigarette smoking and unemployment are more important than Helicobacter pylori infection. Scand J Gastroenterol. 2006;41(2):149–54.

    Article  PubMed  CAS  Google Scholar 

  22. Talley N, Vakil N, Moayyedi P. American gastroenterological association technical review on the evaluation of dyspepsia. Gastroenterology. 2005;129(5):1756–80.

    Article  PubMed  Google Scholar 

  23. Thomson A, Barkun A, Armstrong D, Chiba N, White R, Daniels S, et al. The prevalence of clinically significant endoscopic findings in primary care patients with uninvestigated dyspepsia: the Canadian adult dyspepsia empiric treatment: prompt endoscopy (CADET-PE) study. Aliment Pharmacol Ther. 2003;17(12):1481–91.

    Article  PubMed  CAS  Google Scholar 

  24. Delaney B, McColl K. Review article: Helicobacter pylori and gastro-oesophageal reflux disease. Aliment Pharmacol Ther. 2005;22(Suppl 1):32–40.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

We thank Mrs. Megumi Abe for excellent technical assistance. I had full access to all the data in the study and take responsibility for the integrity of the data and accuracy of the data analysis.

Conflict of interest statement

None.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Seiji Shiota.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Shiota, S., Murakami, K., Takayama, A. et al. Evaluation of Helicobacter pylori status and endoscopic findings among new outpatients with dyspepsia in Japan. J Gastroenterol 44, 930–934 (2009). https://doi.org/10.1007/s00535-009-0095-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00535-009-0095-x

Keywords

Navigation