Mehmet BEKTAŞ, Murat ALKAN, Yusuf ÜSTÜN, İrfan SOYKAN, Ali ÖZDEN

Duodenal ülserli hastalarda Helikobakter pilori eradikasyonunun asit reflüsü üzerine etkisi

Giriş ve Amaç: Helikobakter pilori infeksiyonunun gastroözofageal hastal›ğa karş› koruduğu veya provake edip, etmediği belli değildir ve yap›lan çal›şmalarda da tart›şmal› sonuçlar verilmektedir. Bu çal›şmada Helikobakter pilori eradikasyonunun gastroözofageal reflüye neden olup olmad›ğ› 24 saatlik özfagus pH monitorizasyonuyla araşt›r›lm›şt›r. Gereç ve yöntem: Çal›şmaya endoskopide duodenal ülser saptanan, CLO test, sitoloji ve kültürle Helikobakter pilori infeksiyonu pozitif, reflü semptomlar› olan veya olmayan toplam 20 hasta (K/E: 8/12; yaş ortalamas›: 41 (22-65 y›l) al›nd›. Hastalara 24 saatlik pH monitorizasyonu ve serum gastrin düzeyi için kan al›nd›ktan sonra eradikasyon tedavisi (LAK: lansaprazol, amoksisilin, klaritromisin 14gün) verildi. Eradikasyon tedavisinden 6 ay sonra endoskopik muayene, 24 saatlik pH monitorizasyonu, serum gastrin düzeyi ve Helikobakter pilori testleri tekrarland›. Bulgular: 6 ay sonunda 20 hastan›n 12 tanesi yeniden değerlendirilebildi. 12 hastan›n %66’s›nda Helikobakter pilori eradikasyonu başar›l› oldu. Eradikasyon sağlanan hastalarda eflü semptomu %87’den, %37.5’e (p=0,003); eroziv özofajit 50% 50% (p>0.05), pH

Anahtar Kelimeler:

Doudenal ülser, Helikobakter pilori eradikasyonu, asit reflüsü

The effect of Helicobacter pylori eradication to acid reflux in patients with duodenal ulcer disease

Background: The effect of Helicobacter pylori in provoking or protecting gastro-oesophageal reflux disease is unclear and studies have given conflicting results to date. Aim: To investigate whether Helicobacter pylori eradication causes gastroesophageal reflux disease determined by 24-hour pH monitorization. Metdods: 20 patients (12 men, mean age: 41, range 22-65 years) who were diagnosed duodenal ulcer disease by endoscopical examination and found to be Helicobacter pylori positive by means of CLO test, cytology, culture, with or without reflux symptoms were enrolled in the study. Eradication treatment (LAC: lansaprazol, amocsisilin, claritromisin 14 days) commenced after 24-hour pH monitorization and blood samples drawn for serum gastrin levels. Six months after the eradication treatment, endoscopical examination, 24-hour pH monitorization, serum gastrin levels and Helicobacter pylori tests repeated. Results: After six months 12 of 20 patients committed to reevaluation. Helicobacter pylori infection was eradicated successfully in two thirds of the patient population (66%). Reflux symptoms in eradicated patients before vs after treatment; 87.5% vs 37.5% (p=0.03), esophagitis 50% vs 50% (p>0.05), pH

Keywords:

Duodenal ulcer disease, Helicobacter pylori eradication, acid reflux,

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