Endoscopic Findings Related To Helicobacter Pylori
Author(s):
Alexandre Gomes* and Thelma Larocca Skare
Background: Studies with the latest technologies such as endoscopy with magnification and chromoendoscopy showed that various endoscopic aspects are clearly related to infection by Helicobacter pylori (Hp). The description of different patterns of erythema in gastric body under magnification of images revived interest in identifying these patterns by standard endoscopy.
Aim: To validate the morphologic features of gastric mucosa to conventional gastroscopy Hprelated gastritis allowing predictability of their diagnosis as well as proper targeting biopsies.
Methods: Prospective study of 339 consecutive patients with the standard videoendoscope image analysis were obtained, recorded and stored in a program database. These images were studied with respect to the presence or absence of HP, diagnosed by rapid urease test and/or by histological analysis. Were studied: a) normal mucosa appearance; b) mucosal nodularity; c) diffuse nonspecific erythemaor redness of antrum and body; d) mosaic pattern with focal area of hyperemia; e) erythema in streaks or bands (red streaks); f) raised erosions; g) flat erosions; h) fundic gland polyps. The main exclusion criteria were the use of drugs, Hp pre-treatment and other entities that could affect results.
Results: Applying the exclusion criteria, were included 170 of the 339 patients, of which 52 (30.58%) were positive for Hp and 118 negative. On the positive findings, the most associated with infection were: antralnodularity (26.92%); raised erosion (15.38%) and mosaic pattern in the body (21,15%). On the negative group the normal appearance of the mucosa was 66.94%; red streaks in 9.32%; flat erosions 11.86%; and fundic gland polyps 11.86%. Conclusion: Endoscopic findings are useful in predicting the outcome, localization and targeting of biopsies in gastritis related to Helicobacter pylori infection.The most representative form of Hp related gastritis was the nodularity of the antralmucosa. Diffuse redness and mosaic pattern in the bodyare closely related to Hp infection.Raised erosions are suggestive but not specific to the infection. Normal-appearing forms, red streaks and fundic gland polyposis are related to the negativity of Helicobacter pylori infection. Flat erosions were not conclusive of the presence or absence of Hp.