HELICOBACTER PYLORI INFECTION IN PATIENTS WITH CALCULAR CHOLECYSTITIS: A HOSPITAL BASED STUDY
Abstract
Background: Helicobacter pylori, a gram negative bacillus has been recognised as a public healthproblem and approximately half of the world population has H. pylori infection causes chronic gastritis,peptic ulcer disease and gastric malignancies. Objective of this study was to determine the frequency ofH. pylori infection in patients of chronic calcular cholecystitis. Methods: This cross-sectionaldescriptive study was conducted at Liaquat University Hospital, Hyderabad, Pakistan from April 2010 toSeptember 2010. All patients with history of gallstone presented with acute abdominal pain, dyspepsia,bloating and epigastric discomfort and diagnosed as calcular cholecystitis were further evaluated for thedetection of H. pylori by serology and histopathology. Frequency and percentage of H. pylori infectionin patients with calcular cholecystitis was calculated. Result: Total 100 patients of cholelithiasisunderwent laparoscopic cholecystectomy were recruited. The pain in upper right part of the abdomenwas observed in all 100 patients, fever in 75%, nausea and vomiting in 68%, loss of appetite in 45%,feeling of tiredness or weakness in 22%, headache in 38%, chills in 52%, backache in 58%, pain underthe right shoulder in 45%, heartburn in 67%, belching in 54%, indigestion in 80%, dyspepsia in 90%,bloating in 88%, and epigastric discomfort in 85% patients. Eighty-two percent patients had familyhistory of gallstones. The mean age of overall study population was 48.72±8.78 years and mean age ofH. pylori infected calcular cholecystitis patients was 47.98±5.43 years in male and 48.76±6.68 years infemales. The H. pylori infection was identified in 55% patients with calcular cholecystitis, of which32.7% were males and 67.3% were females (p=0.03, statistically significant). Majority of females (60%)had ≥40 U/ml antibody titre (p=0.917, non-significant). Conclusion: A possible relationship wasidentified between Helicobacter pylori and calcular cholecystitisKeywords: Gallstones, cholilithiasis, calcular cholecystitis, cholelithiatic cholecystitis, HelicobacterpyloriReferences
Huffman JL, Schenker S. Acute acalculous cholecystitis - a
review. Clin Gastroenterol Hepatol. Clin Gastroenterol Hepatol
;8(1):15–22.
Ballal M, Jyothi KN, Antony B, Arun C, Prabhu T, Shivananda
PG. Bacteriological spectrum of cholecystitis and its antibiogram.
Indian J Med Microbiol 2001;19:212–4.
Strasberg SM. Acute Calculous Cholecystitis. N Engl J Med
;358:2804–11.
Cho JY, Han HS, Yoon YS, Ahn KS. Risk factors for acute
cholecystitis and a complicated clinical course in patients with
symptomatic cholelithiasis. Arch Surg 2010;145(4):329–33.
Huang SM, Yao CC, Pan H, Hsiao KM, Yu JK, Lai TJ.
Pathophysiological significance of gallbladder volume changes in
gallstone diseases. World J Gastroenterol 2010;16(34):4341–7.
Girgin S, Gedik E, Taçyildiz IH, Akgün Y, Baç B, Uysal E.
Factors affecting morbidity and mortality in gangrenous
cholecystitis. Acta Chir Belg 2006;106:545–9.
Goodman KJ, Cockburn M. The role of epidemiology in
understanding the health effects of Helicobacter pylori.
Epidemology 2001;12:266–71.
Devrajani BR, Shah SZA, Soomro AA, Devrajani T. Type 2
diabetes mellitus: A risk factor for Helicobacter pylori infection: A
hospital based case-control study. Int J Diabetes Dev Ctries
;30:22–6.
Devrajani BR, Zaman SM, Shah SZA, Devrajani T, Lohana RK,
Das T. Helicobacter pylori: A Cause of Vitamin B12 Deficiency
(A Hospital Based Multidisciplinary Study). World Appl Sci J
;12:1378–81.
Devrajani BR, Devrajani T, Kumar R, Shah SZA, Memon AS.
Helicobacter pylori infection in cirrhotic patients with upper
gastrointestinal bleeding. World Appl Sci J 2010;8:137–40.
Queiroz DMM, Santos A, Oliveira AG, Rocha GA, Moura SB,
Camargo ERS, et al. Isolation of a Helicobacter strain from the
human liver. Gastroenterology 2001;121:1023–4.
Silva CP, Pereira-Lima JC, Oliveira AG, Guerra JB, Marques DL,
Sarmanho L, et al. Association of the presence of Helicobacter in
gall bladder tissue with cholelithiasis and cholecystitis. J Clin
Microbiol 2003;41:5615–8.
Mendez-Sanchez N, Pichardo R, Gonzalez J, Sanchez H, Moreno
M, Barquera F, et al. Lack of association between Helicobacter
species colonization and gall stone disease. J Clin Gastroenterol
;32:138–41.
Kawaguchi M, Saito T, Ohno H, Midorokawa S, Sanji T, Handa
Y, et al. Bacteria closely resembling Helicobacter pylori detected
immunohistologically and genetically in resected gall bladder
mucosa. J Gastroenterol 1996;31:294–8.
Apostolov E, Al Soud WA, Nilsson I, Kornilovska I, Usenko V,
Lyzogubov V, et al. Helicobacter pylori and other Helicobacter
species in gall bladder and liver of patients with chronic
cholecystitis detected by immunological and molecular methods.
Scand J Gastroenterol 2005;40(1):96–102.
Nilsson HO, Mulchandani R, Tranberg KG, Taneera J, Caastedal
M, Glatz E, et al. Helicobacter species identified in liver from
patients with cholangiocarcinoma and hepatocellular carcinoma.
Gastroenterology 2001;120:323–4.
Maurer KJ, Carey MC, Fox JG. Roles of infection, inflammation,
and the immune system in cholesterol gallstone formation.
Gastroenterology 2009;136:425–40.
Lu Y, Zhang BY, Shi JS, Wu LQ. Expression of the bacterial gene
in gallbladder carcinoma tissue and bile. Hepatobiliary Pancreat
Dis Int 2004;3:133–5.
Chen DF, Hu L, Yi P, Liu WW, Fang DC, Cao H. Helicobacter
pylori damages human gallbladder epithelial cells in vitro. World J
Gastroenterol 2008;14:6924–8.
Manoj P. Helicobacter species are associated with possible
increase in risk of biliary lithiasis and benign biliary diseases
World J Surg Oncol 2007,5:94–6.
Apostolov E, Al Soud WA, Nilsson I, Kornilovska I, Usenko V,
Lyzogubov V, et al. Helicobacter pylori and other Helicobacter
species in gall bladder and liver of patients with chronic
cholecystitis detected by immunological and molecular methods.
Scand J Gastroenterol 2005;40:96–102.
Deeba J, Sanjay S, Abida M, Athar K. Helicobacter pylori in gall
bladder disease. Biomed Res 2010;21:437–40.
Karagin PH, Stenram U, Wadström T, Ljungh A. Helicobacter
species and common gut bacterial DNA in gallbladder with
cholecystitis. World J Gastroenterol 2010;16:4817–22.
Myung SJ, Kim MH, Shim KN, Kim YS, Kim EO, Kim HJ, et al.
Detection of Helicobacter pylori DNA in human biliary tree and
its association with hepatolithiasis. Dig Dis Sci 2000;45:1405–12.
Figura N, Cetta F, Angelico M, Montalto G, Cetta D, Pacenti L, et
al. Most Helicobacter pylori infected patients have specific
antibodies and some also have H. pylori antigens and genomic
material in bile: is it a risk factor for gall stone formation? Dig Dis
Sci 1998;43:854–62.
Nilsson HO, Pietroiusti A, Gabrielli M, Zocco MA, Gasbarrini G,
Gasbarrini A. Helicobacter pylori and extragastric diseases--other
Helicobacters. Helicobacter 2005;10(Suppl 1):54–65.
Maurer KJ, Ihrig MM, Rogers AB, Ng V, Bouchard G, Leonard
MR, et al. Identification of cholelithogenic enterohepatic
helicobacter species and their role in murine cholesterol gallstone
formation. Gastroenterology 2005;128:1023–33.
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