An Audit of Endoscopic RUT and Treatment for Helicobacter Pylori in Clinical Practice

• Published in: Journal of pure & applied microbiology : an international research journal of microbiology Vol. 11; no. 2; pp. 941 - 948
• Main Authors: Mohanty, Rina, Swain, Manorama, Kar, Sanjib Kumar, Singh, Shivaram Prasad, Rout, Niranjan
• Format: Journal Article
• Language: English
• Published: Oriental Scientific Publishing Company 01.06.2017; Journal of Pure and Applied Microbiology
• Subjects: Care and treatment; Diagnosis; Endoscopy; Helicobacter infections; helicobacter pylori; Methods; non-ulcer dyspepsia; rapid urease test; India
• ISSN: 0973-7510; 2581-690X
• DOI: 10.22207/JPAM.11.2.34

Helicobacter pylori infection is ubiquitous. Endoscopic Rapid urease test [RUT] is sensitive and specific for diagnosing H. pylori organism during endoscopy. Retrospective analysis of the pattern of RUT performance by endoscopists in Southeast Bengal region in patients evaluated for upper gastrointestinal disorders was performed. The gastroscopy reports of consecutive patients from South-eastern Bengal attending a gastroenterology clinic were studied. The data along with relevant treatment history were entered into a questionnaire and the data was analyzed. Data of 151 patients were analyzed. 16 patients with reflux oesophagitis and growth in duodenum were excluded. Out of 135 patients, 47.4 % and 52.6% had peptic ulcers and non ulcer dyspepsia [NUD] respectively. Rapid urease test (RUT) was positive in 40.62% and 33.80% of peptic ulcer and NUD patients respectively (p = 0.477). However 32.45% patients on "premedication" and 62% without "premedication" were RUT positive, which was statistically significant (p= 0.014). There is also no difference (P >0.05) in endoscopic diagnosis or result of RUT performed by gastroenterologists or nongastroenterologists. 81.25% of RUT positive NUD patients who received Triple therapy for H. pylori did not respond; but all [100%] responded to antidepressants. RUT was performed routinely in all patients undergoing gastroscopy irrespective of diagnosis. The RUT was routinely performed without cognizance of pre-endoscopy treatment. "Pre-treatment" results in erroneous underestimation of H. pylori infection. Antidepressants were superior to triple therapy for NUD even in H. pylori infected patients. Keywords: Helicobacter pylori, Rapid urease test, Non-ulcer dyspepsia.