FONKSİYONEL DİSPEPSİLİ HASTALARDA HELICOBAKTER PYLORI ERADİKASYONUNUN EPİGASTRİK AĞRI SKORU İLE DEĞERLENDİRİLMES

Amaç: Dispepsi, erişkinlerin en sık görülen kronik hastalıklarından biridir. Dispepsi tedavisinin maliyeti gelişmiş ülkelerde sağlık harcamalarının büyük bir kısmını temsil etmektedir. Fonksiyonel dispepsi, multifaktöryel, etiyolojinde Helicobacter pylori’nin suçlandığı bir hastalıktır. Bu çalışmada, “Fonksiyonel dispepsi” alt grubu olan epigastrik ağrı sendromlu hastalarda Helicobacter pylori’nin eradikasyonunun epigastrik ağrı şiddeti üzerine etkilerini semptomatik skorlama yaparak değerlendirmeyi amaçladık. Gereç ve Yöntemler: Fonsiyonel dispepsi teşhisi konulan ve endoskopik biyopsilerinde Helicobacter pylori pozitifliği tespit edilmiş 530 hasta çalışmaya dahil edildi. Hastalara dörtlü eradikasyon tedavisi verildikten sonra hastaların semptom skorları 2. ve 6. ayda tekrar sorgulandı. Bulgular: Çalışmaya 384 kadın (%73) ve 146 erkek (%27) hasta dahil edildi. Yaş ortalaması 39.8±10.6 /yıl idi. Tedavi başlangıcından 2 ay sonra hastaların skorlarına bakıldığında 463 (%88) hastada ağrı skorunda gerileme saptanırken, 67 (%12) hastanın ağrı skorunda değişiklik olmadı. Tedavi sonrası ağrı skorlarında anlamlı düzeyde azalma saptandı (p=0.001). İkinci ve 6. aydaki ağrı skorları karşılaştırıldığında; 6. ayda ki ağrı skoru, başlangıç ve 2. aydaki ağrı skoruna göre daha düşük bulundu. Sonuç: Hem iki hem de altıncı aydaki, semptom skorlarındaki saptadığımız azalma eradikasyon oranları ile ilişkili olabilir. Böylelikle gereksiz test yapılmasının önüne geçilerek sağlık giderleri azaltılabilir. Bu bilgileri teyit edecek daha büyük sayıda hasta grubu içeren ve randomize kontrollü çalışmalara ihtiyaç vardır.

Evaluation of Helicobacter pylori Eradication on Functional Dyspepsia Using Epigastric Pain Scor

Objective: Dyspepsia is one of the most common chronic illnesses of adults in the Western World. Not surprisingly, the cost of dyspepsia treatment represents a large proportion of the healthcare expenses in developed countries. Functional dyspepsia is a multifactorial disease and Helicobacter pylori infection are thougt to be related to Functional dyspepsia. We aimed to evaluate the effects of H. pylori eradication on epigastric pain severity by symptomatic scoring. Material and Methods: We enrolled 530 patients which were diagnosed with functional dyspepsia and H. pylori positivity in endoscopic biopsies. Symptom scores were questioned at 2th month and 6th month after the treatment. All patients received standard quadruple therapy for 14 days. Results: This study was carried out on 384 female and 146 male patients. The mean age of the patients was 39.8±10.6 years. The scores of 463 (88%) patients showed regression after 2 months of treatment and 67(12%) patients had no differences in pain score. We observed statistically significant decrease in pain scores after treatment (p=0.001). When second and sixth month’s pain scores were compared, the pain score at the sixth month was lower than the baseline and second month’s evaluation. Conclusion: We found a decrease in both 2th and 6th month symptom scores which may be related to eradication rates. This finding can prevent unnecessary investigations and reduce medical expenditures for H. pylori eradication. But more randomized studies with large number of patients are needed to confirm this information.

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