HELICOBACTER-PYLORI - A RISK AND SEVERITY FACTOR OF NONSTEROIDAL ANTIINFLAMMATORY DRUG-INDUCED GASTROPATHY

This prospective study aimed to determine the prevalence of Helicobacter pylori infection in relation to the occurrence and severity of NSAIDs induced gastropathy. A total of 111 patients were studied - 66 were taking NSAIDs and 45 were control patients. All patients underwent endoscopy during which antral biopsy specimens were taken to determine H pylori status (Gram and Giemsa staining, urease test, and cultures). The NSAID group comprised: group I, patients without mucosal damage (n=28); group II, patients with gastropathy (n=26); and group III, patients with bleeding associated with NSAID induced gastropathy (n=12). Control patients had neither dyspeptic symptoms nor endoscopic lesions. There were no differences in age, sex ratio, or presence of H pylori (26% v 24%) between the NSAID and the control groups. Among patients taking NSAIDs, H pylori infection was more frequently (p<0.02) diagnosed in those who presented with gastropathy (groups II and III: 37%) than in those without lesions (group I: 11%). The frequency of H pylori infection increased significantly with the severity of gastropathy (group I=11%; group II=31%; group III=50%; p<0.03). H pylori infection was associated with chronic active gastritis (group I=21%; group II=35%; group III=67%; p<0.05). These data suggest that H pylori may be a risk factor of NSAID induced gastropathy.