Eradication of Helicobacter pylori in a population at high risk of gastric cancer
DOI:
https://doi.org/10.51481/amc.v40i2.588Keywords:
H. pylori, tratamiento, erradicación, poblaciones tropicales, cáncer gástricoAbstract
Objective: Eradication of Helicobacter pylori in dyspeptic patients from a population at high risk of gastric cancer.
Background: H. pylori causes chronic gastritis and peptic ulcers; It is also considered a risk factor for gastric cancer. Treatment is highly controversial due to the presence of resistant strains, especially in developing countries. Costa Rica has a high prevalence of H. pylori infection and is the country with the highest mortality rate from gastric cancer.
Method: In 180 dyspeptic patients from a population at high risk of gastric cancer in Costa Rica, the prevalence of H. pylori infection and the rate of eradication at one month were determined by culture, staining and rapid urease in biopsies. after random treatment with cimetidine or against the bacteria (amoxicillin + bismuth subsalicylate).
Results: The bacterium was present in 88.6% of the patients. There is an overlap in the frequency distribution of IgG and IgA antibody levels in infected and uninfected persons. One month after finishing treatment, the bacteria had only been eradicated in 28.9% of the patients.
Conclusions: The high probability of H. pylori strains resistant to antibiotics and of infection and reinfection in tropical populations, require evaluation of eradication treatments, even though these have been successful in other populations. Efforts should be directed to learning about the ecology and transmission routes of the bacteria to prevent infection; as well as the search for a vaccine. Antibody levels against H.pylori do not serve to discriminate infected from uninfected patients.
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