Dispepsili hastalarda gastrointestinal parazitoz sıklığı ve proton pompa inhibitörü kullanımının gastrointestinal parazitoz ve histopatolojik bulgular üzerinde etkisi
Abstract
Amaç: Bu çalışmanın esas amacı üst gastrointestinal sistem (GİS) semptomları olan hastalarda gastrointestinal parazitoz sıklığını araştırmaktı. İkincil amaç ise proton pompa inhibitörleri (PPİ) kullanımının gastrointestinal parazit sıklığı ve histopatolojik bulgular üzerine etkisini değerlendirmekti.
Gereç ve Yöntem: Üst GİS semptomları nedeniyle endoskopi yapılan erişkin hastalar çalışmaya dahil edildi. Hastalardan histopatolojik değerlendirme için biyopsi örneği, parazitolojik inceleme için ise gastrik ve duodenal aspirasyon sıvısı ve gaita örneği alındı.
Bulgular: Çalışmaya toplamda 40 hasta (29 kadın ve 11 erkek) alındı. Kadınların ortalama yaşı 54 ± 14,6, erkeklerin ise 38,4 ± 18,7 yıldı (p = 0,008). Hastalar PPİ kullanmayan [14 hasta (35%)] ve kullanan [26 hasta (65%)] olarak iki gruba ayrıldı. Toplam 3 hastada (7,5%) parazitoz saptandı. Bunlardan ikisi PPİ kullanan grupta, biri ise kullanmayan grupta idi (p = 0,95). Bunun yanı sıra, PPİ kullanımı ile histopatolojik bulgular arasında istatistiksel olarak anlamlı ilişki gözlemlenmedi. Helikobakter pilori pozitifliği ile inflamasyon (p = 0,002) ve intestinal metaplazi (p < 0,001) ilişkili bulundu.
Sonuç: Çalışmamıza alınan hastalar arasında dispeptik şikayetlerin kadınlarda daha fazla olduğu saptandı. PPİ kullanımının gastrointestinal parazit sıklığı ve histopatolojik bulgular üzerinde istatistiksel olarak anlamlı etkisinin olmadığı görüldü. Ek olarak, Helikobakter pilori pozitif hastalarda negatif olanlara göre inflamasyon ve intestinal metaplazi sıklığı anlamlı düzeyde yüksek izlendi.
Keywords
References
- Tack J, Bisschops R, Sarnelli G. Pathophysiology and treatment of functional dyspepsia. Gastroenterology 2004; 127: 1239-55.
- Ford A.C, Moayyedi P. Current guidelines for dyspepsia management. Dig Dis 2008; 26: 225-30.
- Richter J.E. Dyspepsia: organic causes and differential characteristics from functional dyspepsia. Scand J Gastroenterol Suppl 1991;182: 11-6.
- Mandell, Douglas, and Bennet’s Principles and Practice of Infectious Diseases. Eight Edition. Volume 2, Section II. ISBN: 978-1-4557-4801-3.
- Lew E.A. Review Article: Pharmacokinetic concerns in the selection of anti-ulcer therapy. Aliment Pharmacol Ther 1999; 13: 11-6.
- François M, Lévy-Bohbot N, Caron J, et al. Chronic use of proton-pump inhibitors associated with giardiasis: A rare cause of hypomagnesemic hypoparathyroidism? Ann Endocrinol 2008; 69: 446-8.
- Leonard J, Marshall J.K, Moayyedi P. Systematic review of the risk of enteric infection in patients taking acid suppression. Am J Gastroenterol 2007; 102: 2047-56.
- Dixon M.F, Genta R.M, Yardley J.H, et al. Classification and grading of gastritis. The updated Sydney System. International Workshop on the Histopathology of Gastritis, Houston 1994. Am J Surg Pathol 1996; 20: 1161-81.
- Carpenter H.A, Talley N.J. Gastroscopy is incomplete without biopsy: clinical relevance of distinguishing gastropathy from gastritis. Gastroenterology 1995; 108: 917-24.
- Sipponen P, Stolte M. Clinical impact of routine biopsies of the gastric antrum and body. Endoscopy 1997; 29: 671-8.
- Kagevi I, Löfstedt S, Persson L.G. Endoscopic findings and diagnoses in unselected dyspeptic patients at a primary health care center. Scand J Gastroenterol 1989; 24: 145-50.
- Demirceken F.G, Soykan I, Kuloglu Z, et al. Dispepsili hastalarda Giardiazis sıklığı. Akademik Gastroenteroloji Dergisi 2007; 6: 132-6.
- Alver O, Özakin C, Yilmaz E, et al. Uludağ Üniversitesi Tıp Fakültesinde farklı yıllarda bağırsak parazit dağılımlarının değerlendirilmesi. Türkiye Parazitoloji Dergisi 2005; 29: 193-9.
- Degirmenci A, Sevil N, Gunes K, et al. Ege Üniversitesi Tıp Fakültesi Hastanesi Parazitoloji Laboratuvarında 2005 Yılı Boyunca Saptanan Bağırsak Parazitlerinin Dağılımı. Türkiye Parazitol Derg 2007; 31: 133-5.
- Aydin A, Akdemir C. Dumlupınar Üniversitesi Tıp Fakültesi Hastalarında Entamoeba histolytica Prevalansı. Kafkas Univ Vet Fak Derg 2012; 18: A53-A56.
- Alver O, Tore O. Uludağ Üniversitesi Tıp Fakültesindeki bağırsak paraziti olgularının prevalansı ve dağılımı. Turkiye Parazitol Derg 2006; 30: 296-301.
- Zeyrek F.Y, Özbilge H, Zeyrek C.D, et al. Harran Üniversitesi Tıp Fakültesi Mikrobiyoloji Laboratuvarına başvuran hastalarda bağırsak parazitlerinin dağılımı. Türkiye Parazitol Derg 2002; 26: 278-81.
- François M, Lévy-Bohbot N, Caron J, et al. Chronic use of proton-pump inhibitors associated with giardiasis: A rare cause of hypomagnesemic hypoparathyroidism? Ann Endocrinol (Paris) 2008; 69: 446-8.
- Kwok C.S, Arthur A.K, Anibueze C.I, et al. Risk of Clostridium difficile infection with acid suppressing drugs and antibiotics: meta-analysis. Am J Gastroenterol 2012; 107: 1011-9.
- Doglioni C, Boni M.D, Cielo R, et al. Gastric giardiasis. J Clin Pathol 1992; 45: 964-7.
- Sanad M.M, Darwish R.A, Nasr M.E, et al. Giardia lamblia and chronic gastritis. J Egypt Soc Parasitol 1996; 26: 481-95.
- Pépin J, Saheb N, Coulombe M.A, et al. Emergence of fluoroquinolones as the predominant risk factor for Clostridium difficile-associated diarrhea: a cohort study during an epidemic in Quebec. Clin Infect Dis 2005; 41: 1254-60.
- Ahn J.S, Park S.M, Eom C.S, et al. Use of Proton Pump Inhibitor and Risk of Colorectal Cancer: A Meta-analysis of Observational Studies. Korean J Fam Med 2012; 33: 272-9.
- Aygün C, Demirci E, Çayırcı M. Prevalence of gastric cancer precursor lesions in patients with dyspepsia. Dicle Med J 2010; 37: 25-9.
- Sari Y.S, Sander E, Erkan E, et al. Endoscopic diagnoses and CLO test results in 9239 cases, prevalence of Helicobacter pylori in Istanbul, Turkey. J Gastroenterol Hepatol 2007; 22: 1706-11.
The frequency of gastrointestinal parasitosis and the effect of proton pump inhibitor use on gastrointestinal parasitosis and histopathological findings in patients with dyspepsia
Abstract
Aim: The main purpose of this study was to investigate the frequency of gastrointestinal parasites in patients with upper gastrointestinal system (GIS) complaints. The secondary aim was to evaluate the effect of proton pump inhibitors (PPI) on gastrointestinal parasite frequency and histopathological findings.
Materials and Methods: Adult patients who underwent endoscopy for upper GIS symptoms were included in the study. Biopsy specimen for histopathological evaluation, gastric and duodenal aspiration fluid, and stool specimen for parasitological evaluation were also obtained from the patients.
Results: A total of 40 patients (29 female and 11 male) were included in the study. The mean age of women was 54 ± 14.6 and men was 38.4 ± 18.7 years (p = 0.008). The patients were divided into two groups as not using PPI [14 patients (35%)] and using PPI [26 patients (65%)]. Parasites were detected in 3 patients (7.5%). Two of them were from the group using PPI, and one from the group not using PPI (p = 0.95). It was also observed that the effect of PPI on histopathological findings was not statistically significant. Helicobacter pylori positivity was associated with inflammation (p = 0.002) and intestinal metaplasia (p < 0.001).
Conclusion: It was determined that dyspeptic complaints were more common in women. The effect of PPI on histopathological findings or the frequency of parasites were not statistically significant. Inflammation and intestinal metaplasia were found to be statistically higher in Helicobacter pylori positive cases than negatives.
Keywords
References
- Tack J, Bisschops R, Sarnelli G. Pathophysiology and treatment of functional dyspepsia. Gastroenterology 2004; 127: 1239-55.
- Ford A.C, Moayyedi P. Current guidelines for dyspepsia management. Dig Dis 2008; 26: 225-30.
- Richter J.E. Dyspepsia: organic causes and differential characteristics from functional dyspepsia. Scand J Gastroenterol Suppl 1991;182: 11-6.
- Mandell, Douglas, and Bennet’s Principles and Practice of Infectious Diseases. Eight Edition. Volume 2, Section II. ISBN: 978-1-4557-4801-3.
- Lew E.A. Review Article: Pharmacokinetic concerns in the selection of anti-ulcer therapy. Aliment Pharmacol Ther 1999; 13: 11-6.
- François M, Lévy-Bohbot N, Caron J, et al. Chronic use of proton-pump inhibitors associated with giardiasis: A rare cause of hypomagnesemic hypoparathyroidism? Ann Endocrinol 2008; 69: 446-8.
- Leonard J, Marshall J.K, Moayyedi P. Systematic review of the risk of enteric infection in patients taking acid suppression. Am J Gastroenterol 2007; 102: 2047-56.
- Dixon M.F, Genta R.M, Yardley J.H, et al. Classification and grading of gastritis. The updated Sydney System. International Workshop on the Histopathology of Gastritis, Houston 1994. Am J Surg Pathol 1996; 20: 1161-81.
- Carpenter H.A, Talley N.J. Gastroscopy is incomplete without biopsy: clinical relevance of distinguishing gastropathy from gastritis. Gastroenterology 1995; 108: 917-24.
- Sipponen P, Stolte M. Clinical impact of routine biopsies of the gastric antrum and body. Endoscopy 1997; 29: 671-8.
- Kagevi I, Löfstedt S, Persson L.G. Endoscopic findings and diagnoses in unselected dyspeptic patients at a primary health care center. Scand J Gastroenterol 1989; 24: 145-50.
- Demirceken F.G, Soykan I, Kuloglu Z, et al. Dispepsili hastalarda Giardiazis sıklığı. Akademik Gastroenteroloji Dergisi 2007; 6: 132-6.
- Alver O, Özakin C, Yilmaz E, et al. Uludağ Üniversitesi Tıp Fakültesinde farklı yıllarda bağırsak parazit dağılımlarının değerlendirilmesi. Türkiye Parazitoloji Dergisi 2005; 29: 193-9.
- Degirmenci A, Sevil N, Gunes K, et al. Ege Üniversitesi Tıp Fakültesi Hastanesi Parazitoloji Laboratuvarında 2005 Yılı Boyunca Saptanan Bağırsak Parazitlerinin Dağılımı. Türkiye Parazitol Derg 2007; 31: 133-5.
- Aydin A, Akdemir C. Dumlupınar Üniversitesi Tıp Fakültesi Hastalarında Entamoeba histolytica Prevalansı. Kafkas Univ Vet Fak Derg 2012; 18: A53-A56.
- Alver O, Tore O. Uludağ Üniversitesi Tıp Fakültesindeki bağırsak paraziti olgularının prevalansı ve dağılımı. Turkiye Parazitol Derg 2006; 30: 296-301.
- Zeyrek F.Y, Özbilge H, Zeyrek C.D, et al. Harran Üniversitesi Tıp Fakültesi Mikrobiyoloji Laboratuvarına başvuran hastalarda bağırsak parazitlerinin dağılımı. Türkiye Parazitol Derg 2002; 26: 278-81.
- François M, Lévy-Bohbot N, Caron J, et al. Chronic use of proton-pump inhibitors associated with giardiasis: A rare cause of hypomagnesemic hypoparathyroidism? Ann Endocrinol (Paris) 2008; 69: 446-8.
- Kwok C.S, Arthur A.K, Anibueze C.I, et al. Risk of Clostridium difficile infection with acid suppressing drugs and antibiotics: meta-analysis. Am J Gastroenterol 2012; 107: 1011-9.
- Doglioni C, Boni M.D, Cielo R, et al. Gastric giardiasis. J Clin Pathol 1992; 45: 964-7.
- Sanad M.M, Darwish R.A, Nasr M.E, et al. Giardia lamblia and chronic gastritis. J Egypt Soc Parasitol 1996; 26: 481-95.
- Pépin J, Saheb N, Coulombe M.A, et al. Emergence of fluoroquinolones as the predominant risk factor for Clostridium difficile-associated diarrhea: a cohort study during an epidemic in Quebec. Clin Infect Dis 2005; 41: 1254-60.
- Ahn J.S, Park S.M, Eom C.S, et al. Use of Proton Pump Inhibitor and Risk of Colorectal Cancer: A Meta-analysis of Observational Studies. Korean J Fam Med 2012; 33: 272-9.
- Aygün C, Demirci E, Çayırcı M. Prevalence of gastric cancer precursor lesions in patients with dyspepsia. Dicle Med J 2010; 37: 25-9.
- Sari Y.S, Sander E, Erkan E, et al. Endoscopic diagnoses and CLO test results in 9239 cases, prevalence of Helicobacter pylori in Istanbul, Turkey. J Gastroenterol Hepatol 2007; 22: 1706-11.
Details
| Primary Language | English |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Research Articles |
| Authors | |
| Publication Date | September 12, 2022 |
| Submission Date | January 27, 2022 |
| Published in Issue | Year 2022Volume: 61 Issue: 3 |
