Vedat GÖRAL, Mehmet DÖNMEZ, HAKAN TEMİZ, DEDE ŞİT

Nonülser dispepside Helikobakter pilori sıklığı ve eradikasyon tedavisine yanıt

Giriş ve amaç: Nonülser dispepsi etyolojisi net olarak bilinmeyen ve birçok faktörün neden olarak öne sürüldüğü bir hastalıktır. H. pilori de suçlanan faktörlerden biridir. Amacımız nonülser dispepsi ile H. pilori arasındaki ilişikiyi ve eradikasyona yanıtı araştırmaktır. Gereç ve yöntem: Bu çalışmada, 24'ü kadın 20'si erkek olmak üzere 44 nonülser dispepsi hastası (yaş ort. 34,36 ± 13,08) yer almıştır. Kontrol grubu olarak 15 kişilik asemptomatik vaka ( 6 bayan, 9 erkek, yaş ortalaması 32,06 ± 15,09) alınmıştır. Bulgular: Nonülser dispepsi tanılı çalışma hastalarda üreaz testi ile H. pilori varlığı % 56,8 saptanmıştır. Kontrol grubunda ise %20 saptanmıştır. Nonülser dispepsili hastaları ülser benzeri, dismotilite benzeri ve reflü benzeri alt gruplara ayırdığımızda, üreaz testi ile H. pilori pozitifliği, sırasıyla % 61,9, %50,0 ve %55,5 olarak tespit edilmiştir. Üreaz testi ile H. pilori pozitifliği saptanan 27 kişiye eradikasyon tedavisi başlanmıştır. İlaçlarını düzenli kullanarak tedavi bitiminden 6 hafta sonra kontrole gelen 11 hastaya üre nefes testi uygulanmıştır. Üre nefes testi ile 5 hastada (%45, 45) infeksiyonun eradike edildiği gösterildi. Bu 5 hastadan 3'ünde, ilk başvurudaki şikayetler devam etmekteydi. Eradikasyonun sağlanamadığı 6 hastada ilk başvurudaki şikayetleri devam ettiği saptandı. Eradikasyon tedavisi 11 vakadan 2'sinde (%18,1) yüz güldürücü sonuca ulaşmıştır. Sonuç: Nonülser dispepside H. pilori sıklığı kontrol grubuna göre yüksek bulunmuştur, ancak H. pilori eradikasyonu yararlı bulunmamıştır.

Anahtar Kelimeler:

Nonülser dispepsi, Helikobakter pilori

The prevalance of Helicobacter pylori in nonulcer dyspepsia and response to the eradication therapy

Background/aim: The etiology of nonulcer dyspepsia is unknown and many factors are suspected. H. pylori is one of the most often accused factors. Our aim was to research the frequency of H. pylori in nonulcer dyspepsia patients and to determine whether H. pylori is more frequent in nonulcer dyspepsia patients than in asymptomatic patients. We also evaluated the symptomatic improvement in H. pylori-positive patients. Materials and methods: 44 nonulcer dyspepsia patients (24 F, 20 M; mean age: 34.36 ± 13.08) were included in the study. 15 asymptomatic individuals (6 F, 9 M; mean age: 32.06 ± 15.09) were included as a control group. Results: H. pylori positivity was 56.8% according to urease test in nonulcer dyspepsia patients, and 20% in the control group. When we classified nonulcer dyspepsia patients to subgroups as ulcer-like, dysmotility-like and reflux-like, H. pylori positivity was 61.9%, 50% and 55.5%, respectively. Eradication therapy was applied to 27 H. pylori- positive patients in whom positivity was established by means of the urease test. Urea breath test was applied to 11 patients 6 weeks after the end of therapy. It was established that infection was eradicated in 5 patients (45.5%). Complaints were continuing in 6 patients in whom eradication was not achieved. Successful results were achieved in 2 of 11 (18.1%) patients by means of eradication therapy. Conclusion: The H. pylori prevalence is higher in patients with nonulcer dyspepsia than in healthy controls, but H. pylori eradication therapy is not useful.

Keywords:

Non-ulcer dyspepsia, Helicobacter pylori,

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