Endoscopic and histopathological findings in dyspeptic patients with Helicobacter pylori infection

Background: Despite advancements in medicine, gastrointestinal diseases caused by Helicobacter pylori continue to be common in developing countries. This study analyzed gastric mucosal biopsies from the Manipal College of Medical Sciences in Pokhara, Nepal, between January 2017 and June 2018 to determine the prevalence of H. pylori, its association with histopathological changes, and evaluate it using OLGA and OLGIM systems.

Methods: In this analytical cross-sectional study, 80 patients with dyspepsia were included. Biopsies were collected, stored, and labeled. The biopsies were fixed, cut into sections, and stained with routine H&E and Giemsa stains. Evaluations were made using OLGA and OLGIM staging. Statistical analyses were performed using SPSS version 17.0, with significance determined at p<0.05.

Results: Hospital-visiting patients had an 8.41% (38/452) [10.97–5.85%, 95% Confidence Interval (CI)] rate of H. pylori infection, while dyspeptic patients had 47.50% (38/80) (58.44–36.56, 95% CI). Females (48%, 12/25) and patients aged 31–40 (62.50%, 5/8) were mostly affected. The most common clinical presentation and endoscopic findings relating to infection included weight loss (15.79%) and erythema (44.74%), respectively. Provisional and histopathological diagnoses of infected patients mostly included gastritis (50%) and chronic gastritis (63.16%), respectively. Hundred percent of moderate H. pylori infections were associated with normal atrophy and intestinal metaplasia, while 89.66% of mild infections were associated with mild active and chronic inflammation. OLGIM downgraded one OLGA stage 2 and 4 and two OLGA stage 3 cases.

Conclusion: H. pylori infections were most common in adults and females with chronic gastritis. OLGIM was less accurate than OLGA in evaluating high-risk cases, such as adenocarcinomas.

Methods
Age, sex, and clinical diagnoses were noted in the patient information sheet, which was further entered into Microsoft Excel version 10.0.

The data analysis was conducted using the SPSS software, version 17.0. Descriptive statistics were calculated and presented in tables and figures. The Chi-Square test was used to determine the statistical significance of qualitative variables, with a p-value of <0.05 considered significant.