Chandrakumaran, Kandiah; (1992) Duodenal ulcer, Helicobacter pylori and gastric secretion. Doctoral thesis (Ph.D), UCL (University College London).

Text Duodenal_ulcer,_Helicobacter_p.pdf Download (8MB)

Abstract

This study investigated the possibility that Helicobacter pylori is an aetiological factor in the pathogenesis of duodenal ulcer. The aim was to establish whether subjects with duodenal ulcer with Helicobacter pylori had a maximal gastric secretion that was measurably different from that of subjects with duodenal ulcer without Helicobacter pylori. Because Helicobacter pylori is a common infection of individuals without duodenal ulcer, it was felt important to control the observations in the duodenal ulcer group with similar observations in subjects without duodenal ulcer. In 62 subjects with dyspepsia attending for upper gastrointestinal endoscopy, maximal gastric secretion was measured in the 11 non-duodenal ulcer subjects without Helicobacter pylori 20 non-duodenal ulcer subjects with Helicobacter pylori, 21 duodenal ulcer subjects with Helicobacter pylori and 10 duodenal ulcer subjects without Helicobacter pylori Thus the incidence of duodenal ulcer was about 50% whether or not Helicobacter pylori was present. Several tests were used for identification of Helicobacter pylori. In both groups, duodenal ulcer and non-duodenal ulcer, the presence of Helicobacter pylori was associated with a smaller gastric secretion than that in the absence of Helicobacter pylori In subjects with duodenal ulcer the reduction in secretion was 15% and in non-duodenal ulcer it was 18%. Regression analysis indicated that in the absence of Helicobacter pylori there was a strong positive correlation between dose of chronic smoking and maximal gastric secretion in both duodenal ulcer and non-ulcer subjects. However, in the non-duodenal ulcer and duodenal ulcer subjects in whom Helicobacter pylori present, there was no correlation. The enhancing effect of tobacco was apparently nullified by infection with Helicobacter pylori This finding made it unlikely that the association between duodenal ulcer, Helicobacter pylori and reduced gastric secretion was due to a cumulation of aetiological effect between acid and organism. These results lend support to the hypothesis that Helicobacter pylori is not a significant factor in the aetiology of duodenal ulcer. The subjects were followed up and the various details of the follow up studies were consistent with this view.

Download activity - last month

Export as JSONXMLCSV

Download activity - last 12 months

Export as XMLJSONCSV

Downloads by country - last 12 months

Export as JSONXMLCSV

Archive Staff Only

View Item