Introduction:
Helicobacter Pylori has been shown to exist within approximately 30% of the world’s population. It was first identified by Australian Scientists Warren and Marshall who suggested the link between Helicobacter Pylori and peptic ulcer disease. Since then, the World Health Organization has classified the bacteria as being a Class 1 carcinogen. Studies have suggested the incidence of Helicobacter Pylori infections within the bariatric population to be between 11-24%. Additionally, data has suggested that standard Helicobacter Pylori eradication regimens may have a lower incidence of success within bariatric patients.
Method:
A retrospective analysis was undertaken incorporating 235 patients with a BMI>30 who had undergone a laparoscopic sleeve gastrectomy at the Mater Hospital Pimlico between 2014-2016. All patients underwent an upper endoscopy as part of their preoperative workup. A
Helicobacter Pylori Urea Tube (HUT) test was performed in all patients to determine if they carried Helicobacter Pylori. Individuals with a negative HUT test were excluded from the study. Histopathology from operative specimens was reviewed to determine the effectiveness of eradication therapy on treating Helicobacter Pylori infections.
Results:
Of the 235 patients who underwent laparoscopic sleeve gastrectomy,23 (10%) had a positive HUT test on upper endoscopy. Of these individuals, 13 (57%) denied having any symptoms of gastro-oesophageal reflux disease (GORD). Furthermore, 10 (43%) of these patients had evidence of active Helicobacter Pylori infection on histopathology obtained from operative specimens.
Conclusion:
11% of bariatric patients included in the study were found to have Helicobacter Pylori infections based on a positive HUT test performed during upper endoscopy. Alarmingly, over 50% of these individuals had no GORD symptoms to suggest underlying disease. Furthermore, 43% of patients had evidence of active Helicobacter Pylori infection despite treatment with standard eradication therapy.