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Bacteria Causing Gastrointestinal Infections
Published in K. Balamurugan, U. Prithika, Pocket Guide to Bacterial Infections, 2019
B. Vinoth, M. Krishna Raja, B. Agieshkumar
Noninvasive modalities of diagnosing H. pylori include IgG antibody detection, antigen detection in stool sample, and urea breath test. Serology is not useful because it does not identify an active infection. The invasive method of diagnosing H. pylori is by performing an endoscopy and taking biopsies from the stomach, and by subjecting the biopsy specimen for rapid urease test (RUT), histopathological examination (HPE), culture and sensitivity, or PCR study. Classical endoscopic finding in patient with H. pylori infection is the presence of benign-appearing ulcers either in the stomach, usually along the lesser curve or in the first part of the duodenum (Figure 1.3). Duodenal ulcers are more common than gastric ulcers. Often special stains are used to demonstrate H. pylori on HPE (Figure 1.3). The common method of diagnosing H. pylori in clinical practice is by endoscopy and biopsy followed by rapid urease test and HPE.
Reflux and Eosinophilic Oesophagitis
Published in John C Watkinson, Raymond W Clarke, Christopher P Aldren, Doris-Eva Bamiou, Raymond W Clarke, Richard M Irving, Haytham Kubba, Shakeel R Saeed, Paediatrics, The Ear, Skull Base, 2018
Some studies, particularly those using the rapid urease test, failed to demonstrate significant HP involvement in tonsil tissue.62,63 Using PCR techniques, HP detection in tonsils has led to the hypothesis that the tonsil is an extra-gastric reservoir for the organism.64,65 It is further postulated that HP may play a role in tonsillitis. While the findings are interesting, their true significance is unclear. This area may prove clinically relevant but as yet remains within the realm of research interest.
Upper GI
Published in Stephen Brennan, FRCS General Surgery Viva Topics and Revision Notes, 2017
Rapid urease test, also known as the CLO test (Campylobacter-like organism test), is a rapid test for diagnosis of Helicobacter pylori. The basis of the test is the ability of H. pylori to secrete the urease enzyme, which catalyses the conversion of urea to ammonia and bicarbonate. The test is performed at the time of gastroscopy. A biopsy of mucosa is taken from the antrum of the stomach, and is placed into a medium containing urea and an indicator such as phenol red. The urease produced by H. pylori hydrolyses urea to ammonia, which raises the pH of the medium, and changes the colour of the specimen from yellow (negative) to red (positive). There is evidence to suggest that H. pylori moves proximal in the stomach in patients on therapy with proton pump inhibitors, and, as such, samples from the fundus and antrum should be taken in these patients.
Deoxycholic acid induces gastric intestinal metaplasia by activating STAT3 signaling and disturbing gastric bile acids metabolism and microbiota
Published in Gut Microbes, 2022
Duochen Jin, Keting Huang, Miao Xu, Hongjin Hua, Feng Ye, Jin Yan, Guoxin Zhang, Yun Wang
A total of 161 volunteers without Hp infection or cholecystectomy history were recruited to undergo upper endoscopic examination and provide corpus biopsy samples for histological analysis, immunohistochemical staining and RNA extraction in an epidemiological screening program for GC in rural areas of Yangzhou, China. Hp infection status was examined by the rapid urease test. Those with bile reflux into the gastric cavity due to nausea and vomiting caused by the invasive endoscopic procedure were excluded. Finally, obvious primary bile reflux and bile-stained gastric mucosa were observed in 10 subjects under endoscopic views. Among them, 4 subjects were found to have IM based on mucosal specimens, while the remaining subjects were reviewed as histologically normal based on the Updated Sydney System.63 Six volunteers without bile reflux or histopathological IM were randomly selected as the control group for further analysis. General information about the age, sex, bile reflux status and histological assessment of the 16 enrolled subjects is listed in Table S2. This study was approved by the ethics review board of Nanjing Medical University (number 2018-SR-285).
Endoscopic scoring system for gastric atrophy and intestinal metaplasia: correlation with OLGA and OLGIM staging: a single-center prospective pilot study in Korea
Published in Scandinavian Journal of Gastroenterology, 2022
Hee Kyong Na, Kee Don Choi, Young Soo Park, Hwa Jung Kim, Ji Yong Ahn, Jeong Hoon Lee, Kee Wook Jung, Do Hoon Kim, Ho June Song, Gin Hyug Lee, Hwoon-Yong Jung
Biopsies were taken from the same four sites (the lesser curvature of the antrum, the greater curvature of the antrum, the lesser curvature of the corpus, and the greater curvature of the corpus). A rapid urease test (Hp Kit: Chongkungdang Pharm. Corp., Seoul, Korea) was performed for the antrum and the corpus to evaluate Helicobacter pylori infection. Blood sampling was performed to determine H. pylori Ig G antibody titer using Immulite 2000® immunoassay system (Diagnostic Product Corporation, Los Angeles, CA, USA). H. pylori Ig G titer was classified as negative (<0.9 U/mL), equivocal (0.9–1.5 U/mL), and positive (≥1.6 U/mL). H. pylori status was defined as follows: No infection was defined as showing both negative H. pylori tests and having no history of H. pylori eradication. Past infection was defined as positive test H. pylori Ig G and negative rapid urease test results or a history of H. pylori eradication and negative rapid urease test. Current H. pylori infection was defined as positive any of the test results without a history of H. pylori eradication.
Changes in the gut microbiome in relation to the degree of gastric mucosal atrophy before and after Helicobacter pylori eradication
Published in Scandinavian Journal of Gastroenterology, 2022
Satoshi Furune, Kenta Yamamoto, Takashi Honda, Toshihisa Fujiyoshi, Naomi Kakushima, Kazuhiro Furukawa, Eizaburo Ohno, Masanao Nakamura, Ryoji Miyahara, Hiroki Kawashima, Masatoshi Ishigami, Yoshiki Hirooka, Mitsuhiro Fujishiro
Fifteen patients who received EGD and underwent H. pylori eradication at our institution between June 2016 and December 2017 were enrolled in this study. Helicobacter pylori infection was defined when chronic active gastritis was diagnosed by EGD according to the Kyoto Classification of Gastritis [16] and when the result of one or more of the following tests was positive: rapid urease test, urea breath test (cut-off value: 3‰), and serum anti-H. pylori antibody test (cut-off value: 10 IU/mL). Atrophic gastritis in the patients was classified into two groups, the closed group (C-1 to C-3), with non-progressive atrophy, and the open group (O-1 to O-3), with progressive atrophy, based on endoscopic findings according to the Kimura–Takemoto classification by more than two independent endoscopy specialists [9].