Journal of Pure and Applied MicrobiologyVol. 11 No. 2

An Audit of Endoscopic RUT and Treatment for Helicobacter Pylori in Clinical Practice

Rina Mohanty1, Manorama Swain2, Sanjib Kumar Kar3, Shivaram Prasad Singh3 and Niranjan Rout4

1Department of Medicine, 2Department of Biochemistry, 3Department of Gastroenterology, S. C. B. Medical College, Cuttack 753007, Odisha, India. 4A.H. Regional Cancer Centre, Cuttack 753007, Odisha, India.

Received on 17 February 2017 and accepted on 10 April 2017

 

ABSTRACT

Helicobacter Pylori infection is ubiquitous. Endoscopic Rapid urease test [RUT] is sensitive and specific for diagnosing H. Pylori organism during endoscopy. Retrospective analysis of the pattern of RUT performance by endoscopists in Southeast Bengal region in patients evaluated for upper gastrointestinal disorders was performed. The gastroscopy reports of consecutive patients from South-eastern Bengal attending a gastroenterology clinic were studied. The data along with relevant treatment history were entered into a questionnaire and the data was analyzed. Data of 151 patients were analyzed. 16 patients with reflux oesophagitis and growth in duodenum were excluded. Out of 135 patients, 47.4 % and 52.6% had peptic ulcers and non ulcer dyspepsia [NUD] respectively. Rapid urease test (RUT) was positive in 40.62% and 33.80% of peptic ulcer and NUD patients respectively (p = 0.477). However 32.45% patients on “premedication” and 62% without “premedication’’were RUT positive, which was statistically significant (p= 0.014). There is also no difference (P >0.05) in endoscopic diagnosis or result of RUT performed by gastroenterologists or nongastroenterologists. 81.25% of RUT positive NUD patients who received Triple therapy for H. Pylori did not respond; but all [100%] responded to antidepressants. RUT was performed routinely in all patients undergoing gastroscopy irrespective of diagnosis. The RUT was routinely performed without cognizance of pre-endoscopy treatment. “Pre-treatment” results in erroneous underestimation of H. Pylori infection. Antidepressants were superior to triple therapy for NUD even in H. pylori infected patients.

Keywords : Helicobacter pylori, Rapid urease test, Non-ulcer dyspepsia.