New ses of Helicobacter pylori-associated duodenal ulcer

Aim. Generalization of the results obtained through analysis of examinations of new cases of duoclenal ulcer (DU) with patients suffering from DU of different duration, made in two main aspects: the patients' Helicobacter pylori (HP) status determined by histological, bacteriological, immunological studies and rapid urease test and their clinical manifestations, including analysis of risk factors predisposing to peptic ulcer. Materials and Methods. Two groups of patients with DU: 1) 23 new cases; 2) (a group of comparison) 43 patients with DU of different duration were examined. Family history, risk factors (smoking, alcohol consumption, use of nonsteroidal antiinflammatory agents), concurrent diseases were analyzed. Esophagogastroduodenoscopy (EGDS), ph metry, histological, bacteriological studies, rapid urease test and IgG antiHP determination were made. Results. More than 95% of patients with DU were found to have HP just at the moment of diagnosis. New cases of DU have less HP colonization in the mucosa. The best diagnostic results were obtained with a combination of a histological study and a rapid urease test. 74% of new DU cases have scarring-ulcerative deformity of the duodenal bulk and, therefore, the onset of peptic ulcer was asymptomatic or mild. DU accompanied by hemorrhage averaged 4.5%;. A third of new cases have simultaneously 2 ulcer defects in the duodenal bulb. The pains and symptoms of gastric dyspepsia are typical of the two groups of patients; however, of particular significance for their formation are functional disorders in new cases and organic changes in other patients. Conclusion. The comparison of the diagnostic techniques for HP allows the authors to recommend a combination of a histological study and a rapid urease test as the most informative tool.