Kronik Aktif Gastritli Olgularda Helicobacter Pylori Sikliği

OZET Mide mukozasinin inflamasyonu gastrit olarak tanimlanir. H.pylori kucuk (0.5-3 mikron), gram negatif, spiral, kivrimli, 4-6 flagellasi olan hareketli bir bakteridir. Bugun dunya nufusunun yaklasik yarisinin H.pylori ile infekte oldugu kabul edilmektedir. H.pylori ile infekte kisile- rin hemen hepsinde gastrit ve midede fonksiyonel degisiklik, %15-20'sinde peptik ulser, %2-12'sinde ulser komplikasyonu, %1-3'unde mide kanseri, %0,1'inde primer gastrik lenfoma, az oranda da fonksiyonel dispepsi gelisme riski vardir. Bu calismada Mart 2007 ve Mart 2009 tarihleri arasinda Uludag Universitesi Tip Fakultesi Gastroenteroloji poliklinigi veya Genel Dahiliye poliklinigine dispepsi sikayetleriy- le basvurup, sikayetleri neticesinde taniya yonelik endoskopik girisim yapilan ve bunun sonucunda mide biyopsisi kronik aktif gastrit sapta- nan 218 olgunun dosyalari retrospektif olarak incelendi. 218 hastanin 110'unda H.pylori pozitif iken (%50.5), 108'inde H.pylori negatif (%49,5) olarak saptandi ve tani gruplari arasinda H.pylori varligi bakimindan farklilik saptanmadi. Diger calismalarla kiyaslandiginda bu oranin dusuk bulunmasinin sebepleri arasinda ortamda H.pylori'nin yeterli duzeyde olmamasi, ureaz olusturan diger bakterilerin varligi ve ozellikle de H.pylori'nin mide mukozasinda yamali bicimde dagilim gostermesi sayilabilir. Her ne kadar calismamizda H.pylori sikligi diger calismalara nazaran dusuk ciksa da gerek biyopsi sonucuyla, gerek ure nefes testi ile mutlaka H.pylori arastirilmalidir ve gerekli eradikasyon tedavisi yapilmalidir. Tedavi sonrasi mutlaka H.pylori nuksu acisindan hasta degerlendirilmelidir. Erken eradikasyonlarin mide malignitelerini onledigi bilinmektedir. ABSTRACT Inflamation of gastric mucosa is defined as gastritis. H.pylori is a small (0.5- 3 micrometer), gram (-), having 4-6 flagellas and a moveable bacteria. It is aspected that half of the world population has been infected by H. pylori. In all patients whom infected by H.pylori have gastri- tis and functional changes in gastric mucosa. 15-20% of patients have peptic ulcus, 2-12% of patients have a complication of ulcer, 1-3% of patients have gastric malignancy, 0.01% of patients have primer gastric lymphoma and a small portions of patients having risk of devoloping functional dyspepsia. Our study was designed at University of Uludag Medical Faculty. Patients have been selected in Gastroenterogy and General Internal Medicine policlinic among those who has dispeptic complaints. These patients had undergone upper endoscopy and muco- sal biopsy of stomach. 218 patients with chronic atrophic gastritis evaluated retrospectively. H.pylori was found in 110 (50.8%) patients. 108 (49.5%) of patients was H.pylori negative. There was no significiant difference in diagnosis of chronic active gastritis due to H.pylori. This ratio was lower than other studies. This difference is more likely to other urease positive microorganisms, especially patchy infiltration of gastric mucosa by H. pylori. In our study, insidans of H. pylori was lower than other studies. H. pylori must be evaluated by urea breath testing and gastric mucosal biopsy and must be eradicated convenient by medical therapy. Because of recurrence risk of disease, all patients must be reassesed after the eradication therapy. Early eradication of H. pylori might prevent gastric malignancy which is resulted from H. pylori infection.