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.