Evaluation of Helicobacter pylori status and endoscopic findings among new outpatients with dyspepsia in Japan.
OBJECTIVE
The 2005 ACG guidelines for the management of dyspepsia recommend eradication and proton pump inhibitors for patients who are H. pylori-positive and-negative, respectively. To establish Japanese guidelines for dyspepsia, we evaluated H. pylori status and endoscopic findings among outpatients with dyspepsia.


METHODS
The status of H. pylori in dyspeptic patients was determined by measuring urinary levels of anti-H. pylori antibody (RAPIRAN). We then compared the endoscopic findings between H. pylori-positive and -negative patients.


RESULTS
The prevalence of H. pylori among 258 dyspeptic patients was 47.8%, and increased with age (11.1% at age 10-19 years; >50% at age >50 years). The prevalence of H. pylori in each age-group tended to be lower among male than female dyspeptic patients. Endoscopy (n = 138) showed that H. pylori-negative patients rarely had peptic ulcers or gastric cancer, and 84.7% had no endoscopic findings, which was significantly higher when compared to H. pylori-positive patients (67.3%) (p = 0.029).


CONCLUSIONS
Over half of the dyspeptic Japanese patients examined were negative for H. pylori. Patients who are H. pylori-positive should undergo endoscopy to rule out gastric malignancy, peptic ulcers and other diseases.
Shiota
Seiji
S
Department of General Medicine, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama-machi, Yufu, Oita, 879-5593, Japan. m208041@med.oita-u.ac.jp
Murakami
Kazunari
K
Takayama
Akiko
A
Yasaka
Shigeaki
S
Okimoto
Tadayoshi
T
Yoshiiwa
Aoi
A
Kodama
Masaaki
M
Fujioka
Toshio
T
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D002648:Child; D004415:Dyspepsia / Q000382:microbiology*; D016099:Endoscopy, Gastrointestinal; D005260:Female; D016481:Helicobacter Infections / Q000175:diagnosis / Q000453:epidemiology*; D016480:Helicobacter pylori / Q000302:isolation & purification*; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D010437:Peptic Ulcer / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology; D017410:Practice Guidelines as Topic; D015995:Prevalence; D011446:Prospective Studies; D012737:Sex Factors; D013274:Stomach Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology; D055815:Young Adult