PREVALENCE OF OVERWEIGHT AND OBESITY IN HELICOBACTER PYLORI INFECTED PATIENTS

M. H. SOMI, E. FARAMARZI, J. AMIRIFAR, S. NAGHASHI

Research Center of liver and gastrointestinal diseases of Tabriz University, Tabriz, IRAN

Background and objectives: Helicobacter pylori infection is extremely common worldwide. Helicobacter pylori infection may decrease serum ghrelin and increase gastric leptin levels which may, in turn, change body weight .These hormones regulate appetite, food intake, and body composition . Taking in to account the relationship between obesity and many diseases such as gastro-oesophageal reflux disease and cancer, the present study was conducted to determine the prevalence of overweight and obesity in helicobacterpylori infected patients

Method and Material: This study was carried out in 2009-2010 in a group of patients from the Gastroenterological Clinic of the Emam Reza Hospital who had been referred for endoscopic examination of the upper digestive tract. Gastroscopy was performed and multiple biopsies were obtained from the antrum and corpus. Active infection with helicobacter pylori was determined by rapid urease test or histopatholgy. The body weight and body composition(fat mass,free fat mass ,body cell mass and resting metabolic rate ) of 112 patients were determined by Seca scale and Maltron Bioscan 916 respectively. Descriptive statistics were obtained for all study variables.

Results: According to the BMI ranges, 14.3% were obese, 39.2% over weight, 41.1% normal and 5.4 % under weight. The mean body weight , BMI , free fat mass, fat mass, body cell mass and resting metabolic rate of patients were 68.07±1.8 kg and 25.43±0.6 kg/m^{2 ,} 46.86±2.9 kg, 15.82±2.4kg, 1540.41±84.26 kcal/d and 22.5±1.2 kg respectively.

Conclusion: The results of present study showed that more than half of patients were overweight and obese. Taking into account the relationship between obesity and gastro-oesophageal reflux disease which was the main complaint of these patients. Therefore dietary consulting before and during eradication can be helpful in H.pylori infected patients for preventing of weight gain.

ACIDOGENIC FUNCTION OF THE STOMACH IN PATIENTS WITH COMPLICATED GIANT PYLORODUODENAL ULCERS

E.V.STOLARCHUK, E.SH.NAGIYEV, V.N.GORBUNOV

Moscow Medical Academy named after Sechenov, Department of Hospital Surgery No 2, Moscow, RUSSIA

Complicated pyloroduodenal ulcers of large sizes, or, “giant” ulcers, according to the definition, F. Knutsson, always posed a serious problem for surgeons-gastroenterologists. The diameter of the crater of such ulcers may range between 1.5 - 2 cm or more, up to a circular ulceration of pyloroduodenal segment. Giant ulcers of such localization often penetrate into the head of the pancreas and cause to bleeding, perforation, or stenosis. A very important feature of such ulcers is always expressed perivisceritis accompanying them and technical difficulties related with it during the course of the operation. Etiopathogenesis of complicated giant pyloroduodenal ulcers (CGPDU) is studied insufficiently, which substantiates to necessity to specify individual factors of ulcer formation and, in particular, to study acidogenic function of stomach. A few reports available in the literature show significant increase in production of hydrochloric acid in this category of patients. In order to assess the nature of acidogenic function of stomach in complicated giant pyloroduodenal ulcers 27 patients with completed ulcer bleeding were examined. 25- men, and 2- women. Localization and sizes of ulcers were determined during endoscopic and radiological studies, and specified during surgery. In 8 patients an ulcer was located in the pyloric canal area, and in 19 - in the duodenal cap. 48 hours before the study, patients stopped the intake of all medications. The study of the acidogenic function of stomach was carried out by aspiration-titration method. Within the first hour - basal secretion, and within in the next – stimulated secretion was determined. Stimulation of acid production was carried out by A. Kay method. In addition, there was used the sham feeding test, modified by O.S. Noring. Sham feeding test is the most physiological in the assessment of the influence of the vagus nerve on acid production in patients with peptic ulcer disease. Basal production of hydrochloric acid (BPA), maximum, stimulated by histamine (MPA) and stimulated by sham feeding (SF) was determined. According to the results of the survey, in patients with ulcers of the duodenal cap, BPA was 12,9 ± 2,1 mmol/hour, MPA - 25,34 ± 1,3 mmol/ hour, stimulated by sham feeding - 20,44 ± 3,3 mmol/hour. In the group of patients with ulcers of pyloric canal BPA was 7,1 ± 2,5 mmol /hour, MPA - 34.32 mmol /hour, stimulated by sham feeding - 10,3 ± 2,4 mmol/hour. Thus, according to the results of the study, in patients with complicated giant pyloroduodenal ulcers, indicators of production of hydrochloric acid significantly exceed the norm, but do not differ substantially from the respective figures in ulcers of normal sizes. In pyloric channel ulcers, acidogenic function of the stomach is characterized by moderately high levels of basal secretion and expressed production of hydrochloric acid after maximal stimulation by histamine. This nature of acid production in the pyloric channel ulcers significantly differs from the nature of acid production of stomach with the location of ulcers in the duodenal cap, for which basal hypersecretion and moderately high release of hydrochloric acid in response to stimulation by histamine is more typical. This circumstance makes it possible to distinguish ulcers of the pyloric channel in a special group of peptic ulcers, which should be considered in the selection of a method of operation for CGPDU. Sham feeding is a safe and informative method of differential assessment of predominantly cholinergic or predominantly humoral stimulation mechanisms of the production of hydrochloric acid, which is also crucial for the determination of a method of a surgical intervention.

Date: 2014-12-28; view: 898