Role of <em>Helicobacter pylori</em> in the triggering and evolution of hemorrhagic gastro‑duodenal lesions

Popa,Dragos George; Obleagă,Cosmin Vasile; Socea,Bogdan; Serban,Dragos; Ciurea,Marius Eugen; Diaconescu,Marian; Vîlcea,Ionică Daniel; Meșină,Cristian; Mirea,Cecil; Florescu,Dan Nicolae; Baleanu,Vlad Dumitru; Comandasu,Meda; Tudosie,Mihai Silviu; Tribus,Laura Carina; Niculescu,Bogdan

doi:10.3892/etm.2021.10582

Role of Helicobacter pylori in the triggering and evolution of hemorrhagic gastro‑duodenal lesions

Authors:
- Dragos George Popa
- Cosmin Vasile Obleagă
- Bogdan Socea
- Dragos Serban
- Marius Eugen Ciurea
- Marian Diaconescu
- Ionică Daniel Vîlcea
- Cristian Meșină
- Cecil Mirea
- Dan Nicolae Florescu
- Vlad Dumitru Baleanu
- Meda Comandasu
- Mihai Silviu Tudosie
- Laura Carina Tribus
- Bogdan Niculescu
View Affiliations

Affiliations: Department of Plastic and Reconstructive Surgery, Craiova University of Medicine and Pharmacy, 200349 Craiova, Romania, Department of Surgery, Craiova University of Medicine and Pharmacy, 200349 Craiova, Romania, Faculty of Medicine, ‘Carol Davila’ University of Medicine and Pharmacy Bucharest, 020021 Bucharest, Romania, Department of Gastroenterology, Craiova University of Medicine and Pharmacy, 200349 Craiova, Romania, Fourth Department of General Surgery, Emergency University Hospital Bucharest, 050098 Bucharest, Romania, Department of Sports and Health, ‘Constantin Brancusi’ University, 210152 Targu Jiu, Romania
Published online on: August 9, 2021 https://doi.org/10.3892/etm.2021.10582
Article Number: 1147
Copyright: © Popa et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

The majority of studies concerning Helicobacter pylori (H. pylori) are oriented towards the implication of infection with H. pylori in processes that end in the formation of neoplasia, without assessing the impact of the bacterium in triggering acute gastroduodenal hemorrhagic episodes. The present study includes 166 patients with upper digestive hemorrhage, admitted to the ATI Clinic, the Gastroenterology Clinic or to the Surgery II Clinic of the County Emergency Clinical Hospital in Craiova, Romania between 2017 and 2019. All patients were monitored for evolution and received treatment according to current guidelines, and hemorrhagic lesions were biopsied. In the study group, 56.8% of the patients with upper gastrointestinal bleeding (UGIB) were positive for H. pylori and 43.2% were negative. In patients less than 50 years of age, non‑steroidal anti‑inflammatory drug (NSAID) use and H. pylori infection had a cumulative effect in causing bleeding lesions, but in patients older than 50 years of age, the use of NSAIDs was replaced by therapies with oral antiplatelet or anticoagulant agents. The need for hemostasis surgery was more common in patients who exhibited H. pylori‑positive UGIB compared to H. pylori‑negative (16 vs. 9.7%). In patients with H. pylori‑positive hemorrhagic lesions, gastric resection was frequently required to obtain hemostasis. Persistence of H. pylori infection in patients with a history of gastric resection (4.1%) still predisposes to a hemorrhagic or neoplastic complication.

View Figures

View References

1	Obleagă CV, Vere CC, Vîlcea ID, Ciorbagiu MC, Moraru E and Mirea CS: Helicobacter pylori: Types of diseases, diagnosis, treatment and causes of therapeutic failure. J Mind Med Sci. 3:156–161. 2016.
2	Kuipers EJ, Thijs JC and Festen HP: The prevalence of Helicobacter pylori in peptic ulcer disease. Aliment Pharmacol Ther. 9 (Suppl 20):S59–S69. 1995.PubMed/NCBI
3	Hentschell E, Brandstätter G, Dragosics B, Hirschl AM, Nemec H, Schütze K, Taufer M and Wurzer H: Effect of ranitidine and amoxycillin plus metronidazole on the eradication of Helicobacter pylori and the recurrence of duodenal ulcer. N Engl J Med. 328:308–312. 1993.PubMed/NCBI View Article : Google Scholar
4	Gisbert JP, Khorrami S, Carballo F, Calvet X, Gene E and Dominguez-Munoz E: Meta-analysis: Helicobacter pylori eradication therapy vs. antisecretory non-eradication therapy for the prevention of recurrent bleeding from peptic ulcer. Aliment Pharmacol Ther. 19:617–629. 2004.PubMed/NCBI View Article : Google Scholar
5	Guo CG, Cheung KS, Zhang F, Chan EW, Chen L, Wong ICK and Leung WK: Delay in retreatment of Helicobacter pylori infection increases risk of upper gastrointestinal bleeding. Clin Gastroenterol Hepatol. 19:314–322.e2. 2021.PubMed/NCBI View Article : Google Scholar
6	Gisbert JP and Abraira V: Accuracy of Helicobacter pylori diagnostic tests in patients with bleeding peptic ulcer: A systematic review and meta-analysis. Am J Gastroenterol. 101:848–863. 2006.PubMed/NCBI View Article : Google Scholar
7	Stolte M and Meining A: The updated Sydney system: Classification and grading of gastritis as the basis of diagnosis and treatment. Can J Gastroenterol. 15:591–598. 2001.PubMed/NCBI View Article : Google Scholar
8	Mao T, Wang Y, Yin F, Zhao Q, Yang L, Ding X and Tian Z: Association of endoscopic features of gastric mucosa with Helicobacter pylori infection in Chinese patients. Gastroenterol Res Pract. 2016(6539639)2016.PubMed/NCBI View Article : Google Scholar
9	Slăvescu KC, Șarban C, Pîrvan A, Gheban D, Mărgescu C and Miu N: Prevalence of Helicobacter pylori infection in children with gastritis and peptic ulcer disease in north-western and central Romania. Med Pharmacy Rep. 85:457–462. 2012.
10	Megraud F: H. pylori antibiotic resistance: Prevalence, importance and advances in testing. Gut. 53:1374–1384. 2004.PubMed/NCBI View Article : Google Scholar
11	Park S and Chun HJ: Helicobacter pylori infection following partial gastrectomy for gastric cancer. World J Gastroenterol. 20:2765–2770. 2014.PubMed/NCBI View Article : Google Scholar
12	Testerman TL and Morris J: Beyond the stomach: An updated view of Helicobacter pylori pathogenesis, diagnosis, and treatment. World J Gastroenterol. 20:12781–12808. 2014.PubMed/NCBI View Article : Google Scholar
13	Wroblewski LE, Peek RM Jr and Wilson KT: Helicobacter pylori and gastric cancer: Factors that modulate disease risk. Clin Microbiol Rev. 23:713–739. 2010.PubMed/NCBI View Article : Google Scholar
14	Conteduca V, Sansonno D, Lauletta G, Russi S, Ingravallo G and Dammacco F: H. pylori infection and gastric cancer: State of the art (Review). Int J Oncol. 42:5–18. 2013.PubMed/NCBI View Article : Google Scholar
15	Alberto P and Franceschi M: Helicobacter pylori infection in older people. World J Gastroenterol. 20:6364–6373. 2014.PubMed/NCBI View Article : Google Scholar
16	Constantin VD, Paun S, Ciofoaia VV, Budu V and Socea B: Multimodal management of upper gastrointestinal bleeding caused by stress gastropathy. J Gastrointestin Liver Dis. 18:279–284. 2009.PubMed/NCBI
17	Pilotto A: Aging and upper gastrointestinal disorders. Best Pract Res Clin Gastroenterol. 18 (Suppl):S73–S81. 2004.PubMed/NCBI View Article : Google Scholar
18	Venerito M, Schneider C, Costanzo R, Breja R, Röhl FW and Malfertheiner P: Contribution of Helicobacter pylori infection to the risk of peptic ulcer bleeding in patients on nonsteroidal anti-inflammatory drugs, antiplatelet agents, anticoagulants, corticosteroids and selective serotonin reuptake inhibitors. Aliment Pharmacol Ther. 47:1464–1471. 2018.PubMed/NCBI View Article : Google Scholar
19	Pilotto A and Franceschi M: Helicobacter pylori infection in older people. World J Gastroenterol. 20:6364–6373. 2014.PubMed/NCBI View Article : Google Scholar
20	Lanas A, Dumonceau JM, Hunt RH, Fujishiro M, Scheiman JM, Gralnek IM, Campbell HE, Rostom A, Villanueva C and Sung JJY: Non-variceal upper gastrointestinal bleeding. Nat Rev Dis Primers. 4(18020)2018.PubMed/NCBI View Article : Google Scholar
21	Pilotto A, Franceschi M, Leandro G, Paris F, Cascavilla L, Longo MG, Niro V, Andriulli A, Scarcelli C and Di Mario F: Proton-pump inhibitors reduce the risk of uncomplicated peptic ulcer in elderly either acute or chronic users of aspirin/non-steroidal anti-inflammatory drugs. Aliment Pharmacol Ther. 20:1091–1097. 2004.PubMed/NCBI View Article : Google Scholar
22	Narayanan M, Reddy KM and Marsicano E: Peptic ulcer disease and Helicobacter pylori infection. Mo Med. 115:219–224. 2018.PubMed/NCBI
23	Zapata-Colindres JC, Zepeda-Gómez S, Montaño-Loza A, Vázquez-Ballesteros E, De Jesús Villalobos J and Valdovinos-Andraca F: The association of Helicobacter pylori infection and nonsteroidal anti-inflammatory drugs in peptic ulcer disease. Can J Gastroenterol. 20:277–280. 2006.PubMed/NCBI View Article : Google Scholar
24	Zhang L, Eslick GD, Xia HH, Wu C, Phung N and Talley NJ: Relationship between alcohol consumption and active Helicobacter pylori infection. Alcohol Alcohol. 45:89–94. 2010.PubMed/NCBI View Article : Google Scholar
25	Hosseininasab Nodoushan SA and Nabavi A: The interaction of Helicobacter pylori infection and type 2 diabetes mellitus. Adv Biomed Res. 8(15)2019.PubMed/NCBI View Article : Google Scholar
26	He C, Yang Z and Lu NH: Helicobacter pylori infection and diabetes: Is it a myth or fact? World J Gastroenterol. 20:4607–4617. 2018.PubMed/NCBI View Article : Google Scholar
27	Suceveanu AI, Stoian AP, Parepa I, Voinea C, Hainarosie R, Manuc D, Nitipir C, Mazilu L and Suceveanu AP: Gut microbiota patterns in obese and type 2 diabetes (T2D) patients from romanian black sea coast region. Rev Chim. 69:2260–2267. 2018.
28	Okushin K, Tsutsumi T, Ikeuchi K, Kado A, Enooku K, Fujinaga H, Moriya K, Yotsuyanagi H and Koike K: Helicobacter pylori infection and liver diseases: Epidemiology and insights into pathogenesis. World J Gastroenterol. 24:3617–3625. 2018.PubMed/NCBI View Article : Google Scholar
29	Tsai CE, Liang CM, Lee CH, Kuo YH, Wu KL, Chiu YC, Tai WC and Chuah SK: First-line Helicobacter pylori eradication among patients with chronic liver diseases in Taiwan. Kaohsiung J Med Sci. 32:397–402. 2016.PubMed/NCBI View Article : Google Scholar
30	Gheorghe G, Stoian AP, Gaman M, Socea B, Neagu TP, Stanescu AMA, Bratu OG, Mischianu DLD, Suceveanu AI and Diaconu CC: The Benefits and Risks of Antioxidant Treatment in Liver Diseases. Rev Chim. 70(651)2019.
31	Huan JQ, Sridhar S and Hunt RH: Role of Helicobacter pylori infection and nonsteroidal anti-inflammatory drugs in peptic-ulcer disease: A meta-analysis. Lancet. 359:14–22. 2002.PubMed/NCBI View Article : Google Scholar
32	Braden B: Diagnosis of Helicobacter pylori infection. BMJ. 344(828)2012.PubMed/NCBI View Article : Google Scholar
33	Lee JY and Kim N: Diagnosis of Helicobacter pylori by invasive test: Histology. Ann Transl Med. 3(10)2015.PubMed/NCBI View Article : Google Scholar
34	Alius C, Tudor C, Badiu CD, Dascalu AM, Smarandache CG, Sabau AD, Tanasescu C, Balasescu SA and Serban D: Indocyanine green-enhanced colorectal surgery-between being superfluous and being a game-changer. Diagnostics (Basel). 10(742)2020.PubMed/NCBI View Article : Google Scholar
35	Kokkola A, Rautelin H, Puolakkainen P, Sipponen P, Färkkilä M, Haapiainen R and Kosunen TU: Diagnosis of Helicobacter pylori infection in patients with atrophic gastritis: Comparison of histology, 13C-urea breath test, and serology. Scand J Gastroenterol. 35:138–141. 2000.PubMed/NCBI View Article : Google Scholar
36	Loffeld RJ, Stobberingh E, Flendrig JA and Arends JW: Helicobacter pylori in gastric biopsy specimens. Comparison of culture, modified giemsa stain, and immunohistochemistry. A retrospective study. J Pathol. 165:69–73. 1991.PubMed/NCBI View Article : Google Scholar
37	Testoni PA, Colombo E, Cattani L, Longhi M, Bagnolo F, Lella F, Buizza M and Scelsi R: Helicobacter pylori serology in chronic gastritis with antral atrophy and negative histology for Helicobacter-like organisms. J Clin Gastroenterol. 22:182–185. 1996.PubMed/NCBI View Article : Google Scholar
38	Kang HY, Kim N, Park YS, Hwang JH, Kim JW, Jeong SH, Lee DH, Jung HC and Song IS: Progression of atrophic gastritis and intestinal metaplasia drives Helicobacter pylori out of the gastric mucosa. Dig Dis Sci. 51:2310–2315. 2006.PubMed/NCBI View Article : Google Scholar
39	Park YH and Kim N: Review of atrophic gastritis and intestinal metaplasia as a premalignant lesion of gastric cancer. J Cancer Prev. 20:25–40. 2015.PubMed/NCBI View Article : Google Scholar
40	Penston JG: A decade of experience with long-term continuous treatment of peptic ulcers with H2-receptor antagonists. Aliment Pharmacol Ther. 7 (Suppl 2):S27–S33. 1993.PubMed/NCBI View Article : Google Scholar
41	Laine LA: Helicobacter pylori and complicated ulcer disease. Am J Med. 100 (Suppl):S52–S59. 1996.PubMed/NCBI View Article : Google Scholar
42	Campuzano-Maya G: Hematologic manifestations of Helicobacter pylori infection. World J Gastroenterol. 20:12818–12838. 2014.PubMed/NCBI View Article : Google Scholar
43	Obleagă CV, Vere CC, Pătraşcu AM, Moraru E, Crafciuc AV, Foarfă MC, Mogoantă SŞ, Streba CT, Bondari S, Paitici Ş, et al: Severe upper gastrointestinal bleeding determined by a gastric lymphoma associated with Helicobacter pylori-positive atrophic gastritis. Rom J Morphol Embryol. 58:611–617. 2017.PubMed/NCBI
44	Obleagă CV, Vere CC, Mogoanţa S, Firuț C, Meșina C, Ciorbagiu MC, Mirea CS and Vîlcea ID: Upper gastrointestinal bleeding-initial manifestation of pancreatic head carcinoma. Curr Health Sci J. 43:236–240. 2017.PubMed/NCBI View Article : Google Scholar
45	Serban D, Vancea G, Balasescu SA, Socea B, Tudor C and Dascalu AM: Informed consent in all surgical specialties: From legal obligation to patient satisfaction. Rom J Leg Med. 28:317–321. 2020.
46	Constantin VD, Socea B, Sireţeanu G and Popa F: Epidemiological aspects and risk factors in the outcome of variceal eso-gastric bleeding at cirrhosis patients. J Appl Quant Meth. 3:316–324. 2008.
47	Fometescu SG, Costache M, Coveney A, Oprescu SM, Serban D and Savlovschi C: Peritoneal fibrinolytic activity and adhesiogenesis. Chirurgia (Bucur). 108:331–340. 2013.PubMed/NCBI