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Changing prevalence of Helicobacter pylori infection and peptic ulcer among dyspeptic Sardinian patients

Dore, Maria Pina and Marras, Giuseppina and Rocchi, Chiara and Soro, Sara and Loria, Maria Francesca and Bassotti, Gabrio and Graham, David Y. and Malaty, Hoda M. and Pes, Giovanni Mario (2015) Changing prevalence of Helicobacter pylori infection and peptic ulcer among dyspeptic Sardinian patients. Internal and Emergency Medicine (in press). ISSN 1828-0447. Article.

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DOI: 10.1007/s11739-015-1218-4

Abstract

Over the past 50 years, the prevalence of Helicobacter pylori infection has fallen as standards of living improved. The changes in the prevalence of infection and its manifestations (peptic ulcer disease and gastric mucosal lesions) were investigated in a large cohort of Sardinians undergoing upper endoscopy for dyspepsia. A retrospective observational study was conducted involving patients undergoing endoscopy for dyspepsia from 1995 to 2013. H. pylori status was assessed by histology plus the rapid urease test or 13C-UBT. Gastric mucosal lesions were evaluated histologically. Data including non-steroidal anti-inflammatory drugs (NSAIDs) use and the presence of peptic ulcers were collected. The prevalence of H. pylori was calculated for each quartile and for each birth cohort from 1910 to 2000. 11,202 records were retrieved for the analysis (62.9 % women). The overall prevalence of H. pylori infection was 43.8 % (M: 46.6 % vs. F: 42.0 %; P = 0.0001). A dramatic decrease in the prevalence of infection occurred over the 19-year observation period. The birth cohort effect was evident in each category (quartile) reflecting the continuous decline in H. pylori acquisition. Over time, the prevalence of peptic ulcers also declined, resulting in an increase in the proportion of H. pylori negative/NSAID positive and H. pylori negative/NSAID negative peptic ulcers. The prevalence of gastric mucosal changes also declined despite aging. The decline in H. pylori prevalence over time likely reflects the improvement in socioeconomic conditions in Sardinia such that H. pylori infection and its clinical outcomes including peptic ulcer are becoming less frequent even among dyspeptic patients.

Item Type:Article
ID Code:10940
Status:In Press
Refereed:Yes
Uncontrolled Keywords:Dyspepsia, epidemiology, Helicobacter pylori infection
Subjects:Area 05 - Scienze biologiche > BIO/12 Biochimica clinica e biologia molecolare clinica
Divisions:001 Università di Sassari > 01-a Nuovi Dipartimenti dal 2012 > Medicina Clinica e Sperimentale
Publisher:Springer Milan
ISSN:1828-0447
Deposited On:26 May 2015 10:17

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