Author/Editor		Skok, Pavel; Križman, Igor; Skok, Marija
Title		Refluksna bolezen požiralnika, peptična razjeda in okužba s Helicobacter pylori - prospektivna, kontrolirana raziskava
Translated title		Esophageal reflux disease, peptic ulcer and Helicobacter pylori infection - a prospective, controlled study
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 72, št. 2
Publication year		2003
Volume		str. 71-7
Language		slo
Abstract		Background. A possible association of esophageal reflux disease with peptic ulcer, Helicobacter pylori infection or the results of eradication, has not been elucidated. It is an alarming fact that in developed countries the incidence of esophageal adenocarcinoma, which is associated with reflux disease, is increasing. Aim. The aim of the study was to establish the prevalence of esophageal reflux disease after eradication of H. pylori infection in patients with hemorrhaging and nonhemorrhaging peptic ulcer of stomach or duodenum. Patients and methods. Study was approved in 1998 by the Slovenian Medical Ethics Committee (No. 90/09/98). Prospective, controlled and randomized, carried out between 19982000. The study included 80 patients (50 male and30female, av. age 57.5 years, SD ± 17.1, range 22-80 years) in which endoscopy confirmed hemorrhage from peptic ulcer of stomach or duodenum and HP infection. The control group was made up of 80 patients (50 male and 30 female, av. age 56.8 years, SD ± 16 8, range 19-80 years) with peptic ulcer of stomach or duodenum and H. pylori infection in the same period of time. In all cases the recommended drug combinations were used in the treatment of the infection: a proton pump inhibitor, omeprazol (4 weeks), and combination of antibiotics, claritromycin and metronidazole or with regard to the antibiogram (1 week). The therapeutic success was ascertained endoscopically four weeks after inclusion in the study. Infection eradication was confirmed by the rapid urease test and histologic investigation of the gastric mucosa. One year later, in the course of follow-up, in patients with endoscopic investigations, 24-hour pH-metry or fiberoptic spectrophotometric bilirubin determination, bilimetry, we tried to establish signs of esophageal reflux disease. (Abstract truncated at 2000 characters).
Summary		Izhodišča. Morebitna povezanost refluksne bolezni požiralnika s peptično razjedo, okužbo s Helicobacter pylori ali s posledicami izkoreninjenja okužbe ni pojasnjena. Skrb zbujajoče je dejstvo, da v razvitih deželah narašča pojavnost adenokarcinoma požiralnika, ki ga povezujejo z refluksno boleznijo. Namen raziskave. Ugotoviti pogostost pojava refluksne bolezni požiralnika po izkoreninjenju okužbe s H. pylori pri bolnikih s krvavečo in nekrvavečo peptično razjedo želodca ali dvanajstnika. Bolniki in metode. Raziskavo je odobrila Republiška strokovna komisija za medicinsko etična vprašanja leta 1998 (številka sklepa 90/09/98). Prospektivna, kontrolirana in randomizirana, potekala je v obdobju 1998-2000. V študijsko skupino smo vključili 80 bolnikov (50 moških in 30 žensk, povprečne starosti 57,5 leta, SD ± 17,1 leta, v razponu od 22-80 let), pri katerih smo endoskopsko potrdili krvavečo peptično razjedo želodca ali dvanajstnika in okužbo s H. pylori. V kontrolno skupino smo vključili 80 bolnikov (5O moških in 30 žensk, povprečne starosti 56,8 leta, SD ± I6 8, v razponu od 19-80) s peptično razjedo želodca ali dvanajstnika, okuženih z bakterijo, v istem časovnem obdobju. Pri vseh bolnikih smo zdravili okužbo s priporočenimi kombinacijami zdravil: zaviralcem protonske črpalke, omeprazolom (štiri tedne) in kombinacijo antibiotikov, klaritromicinom in metronidazolom ali glede na antibiogram (en teden). Uspešnost zdravljenja smo ugotavjali endoskopsko štiri tedne po vključitvi v raziskavo, izkoreninjenje okužbe smo potrdili s hitrim ureaznim testom in histološkim pregledom sluznice želodca. V poteku spremljanja, po enem letu, smo pri bolnikih z endoskopskimi preiskavami, s 24-urno pH-metrijo ali fiberoptičnim spektrofotometričnim določanjem bilirubina in bilimetrijo skušali ugotoviti znake refluksne bolezni požiralnika. (Izvleček prekinjen pri 2000 znakih).
Descriptors		GASTROESOPHAGEAL REFLUX PEPTIC ULCER HEMORRHAGE HELICOBACTER PYLORI PEPTIC ULCER TREATMENT OUTCOME PROSPECTIVE STUDIES