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What is the Best Method to Diagnose Helicobacter Infection in Bleeding Peptic Ulcers ? : A Prospective Trial

BACKGROUND : It has been debated which diagnostic test should be preferred for the diagnosis of Helicobacter pylori (HP) in patients with peptic ulcer diseases. Several limitations are reported in bleeding peptic ulcers because of intragastric blood and possibility of changed numbers of organisms by...

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Autores principales: Chung, Il-Kwun, Hong, Soo-Jin, Kim, Eun-Joo, Cho, Joo-Young, Kim, Hong-Soo, Park, Sang-Heum, Lee, Moon-Ho, Kim, Sun-Joo, Shim, Chan-Sup
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Association of Internal Medicine 2001
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4531724/
https://www.ncbi.nlm.nih.gov/pubmed/11769572
http://dx.doi.org/10.3904/kjim.2001.16.3.147
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author Chung, Il-Kwun
Hong, Soo-Jin
Kim, Eun-Joo
Cho, Joo-Young
Kim, Hong-Soo
Park, Sang-Heum
Lee, Moon-Ho
Kim, Sun-Joo
Shim, Chan-Sup
author_facet Chung, Il-Kwun
Hong, Soo-Jin
Kim, Eun-Joo
Cho, Joo-Young
Kim, Hong-Soo
Park, Sang-Heum
Lee, Moon-Ho
Kim, Sun-Joo
Shim, Chan-Sup
author_sort Chung, Il-Kwun
collection PubMed
description BACKGROUND : It has been debated which diagnostic test should be preferred for the diagnosis of Helicobacter pylori (HP) in patients with peptic ulcer diseases. Several limitations are reported in bleeding peptic ulcers because of intragastric blood and possibility of changed numbers of organisms by medication. This study was designed to find out the best method for diagnosis of HP infection, in aspect of deciding the times of detection and the specific tests in bleeding peptic ulcers. METHODS : We prospectively examined histology, rapid urease test (CLO test), urea breath test ((13)C-UBT) and serology in HP diagnostics in 32 patients with bleeding peptic ulcers to detect HP infection. Each test was performed two times (four methods at first 24 hours and former three methods at 7(th) day after initial therapeutic endoscopy). We evaluated the sensitivity of each test, compared the two-times results and evaluated the effect of these tests to an outcome of endoscopic hemostasis. RESULTS : Diagnostic sensitivities of histology, CLO test, (13)C-UBT and serology are 75%, 67.8%, 100% and 100% at first endoscopy, and 71.4%, 78.5%, 89.3% at 7th day endoscopy, respectively. Histologic study and CLO test had diagnostic limitation at emergent first endoscopy contrary to UBT (p<0.01). Histologic study, CLO test and UBT have limitations at 7(th) day endoscopy. Only 3 patients (9.4%) rebled with subsequent complete endoscopic hemostasis and all diagnostic tests at initial endoscopy did not influence the outcome of hemostasis. CONCLUSION : First day histologic and CLO tests are inadequate methods in detecting HP infection in patients with bleeding peptic ulcers. 7-day histologic, CLO test and UBT have a low sensitivity. First-day UBT can be a standard test to diagnose HP infection in patients with bleeding peptic ulcers.
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spelling pubmed-45317242015-10-02 What is the Best Method to Diagnose Helicobacter Infection in Bleeding Peptic Ulcers ? : A Prospective Trial Chung, Il-Kwun Hong, Soo-Jin Kim, Eun-Joo Cho, Joo-Young Kim, Hong-Soo Park, Sang-Heum Lee, Moon-Ho Kim, Sun-Joo Shim, Chan-Sup Korean J Intern Med Original Article BACKGROUND : It has been debated which diagnostic test should be preferred for the diagnosis of Helicobacter pylori (HP) in patients with peptic ulcer diseases. Several limitations are reported in bleeding peptic ulcers because of intragastric blood and possibility of changed numbers of organisms by medication. This study was designed to find out the best method for diagnosis of HP infection, in aspect of deciding the times of detection and the specific tests in bleeding peptic ulcers. METHODS : We prospectively examined histology, rapid urease test (CLO test), urea breath test ((13)C-UBT) and serology in HP diagnostics in 32 patients with bleeding peptic ulcers to detect HP infection. Each test was performed two times (four methods at first 24 hours and former three methods at 7(th) day after initial therapeutic endoscopy). We evaluated the sensitivity of each test, compared the two-times results and evaluated the effect of these tests to an outcome of endoscopic hemostasis. RESULTS : Diagnostic sensitivities of histology, CLO test, (13)C-UBT and serology are 75%, 67.8%, 100% and 100% at first endoscopy, and 71.4%, 78.5%, 89.3% at 7th day endoscopy, respectively. Histologic study and CLO test had diagnostic limitation at emergent first endoscopy contrary to UBT (p<0.01). Histologic study, CLO test and UBT have limitations at 7(th) day endoscopy. Only 3 patients (9.4%) rebled with subsequent complete endoscopic hemostasis and all diagnostic tests at initial endoscopy did not influence the outcome of hemostasis. CONCLUSION : First day histologic and CLO tests are inadequate methods in detecting HP infection in patients with bleeding peptic ulcers. 7-day histologic, CLO test and UBT have a low sensitivity. First-day UBT can be a standard test to diagnose HP infection in patients with bleeding peptic ulcers. Korean Association of Internal Medicine 2001-09 /pmc/articles/PMC4531724/ /pubmed/11769572 http://dx.doi.org/10.3904/kjim.2001.16.3.147 Text en Copyright © 2001 The Korean Association of Internal Medicine This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Chung, Il-Kwun
Hong, Soo-Jin
Kim, Eun-Joo
Cho, Joo-Young
Kim, Hong-Soo
Park, Sang-Heum
Lee, Moon-Ho
Kim, Sun-Joo
Shim, Chan-Sup
What is the Best Method to Diagnose Helicobacter Infection in Bleeding Peptic Ulcers ? : A Prospective Trial
title What is the Best Method to Diagnose Helicobacter Infection in Bleeding Peptic Ulcers ? : A Prospective Trial
title_full What is the Best Method to Diagnose Helicobacter Infection in Bleeding Peptic Ulcers ? : A Prospective Trial
title_fullStr What is the Best Method to Diagnose Helicobacter Infection in Bleeding Peptic Ulcers ? : A Prospective Trial
title_full_unstemmed What is the Best Method to Diagnose Helicobacter Infection in Bleeding Peptic Ulcers ? : A Prospective Trial
title_short What is the Best Method to Diagnose Helicobacter Infection in Bleeding Peptic Ulcers ? : A Prospective Trial
title_sort what is the best method to diagnose helicobacter infection in bleeding peptic ulcers ? : a prospective trial
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4531724/
https://www.ncbi.nlm.nih.gov/pubmed/11769572
http://dx.doi.org/10.3904/kjim.2001.16.3.147
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