CO-EXISTENCE OF HELICOBACTER PYLORI IN GASTRIC AND GALLBLADDER MUCOSA IN CHOLECYSTITIS PATIENTS: A CROSS-SECTIONAL STUDY
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Keywords
Helicobacter pylori, cholecystitis, gastric mucosa, gallbladder mucosa, cross-sectional study, Pakistan
Abstract
Background: Helicobacter pylori (H. pylori) is a gram-negative bacterium often linked to gastric conditions, such as gastritis, peptic ulcers, and gastric cancer. Recently, its potential role in biliary diseases, including cholecystitis and cholelithiasis, has been explored. Cholecystectomy remains the standard treatment for cholecystitis, yet the involvement of H. pylori in gallbladder pathology is not well understood.
Objective: This study aims to determine the prevalence of H. pylori in both gastric and gallbladder mucosa in cholecystitis patients and assess any associations between H. pylori infection and demographic factors such as age, gender, smoking status, and body mass index (BMI).
Methods: We conducted a cross-sectional study over one year at King Edward Medical University/ Mayo Hospital, Pakistan in the duration from November, 2023 to April, 2024. A total of 141 patients with diagnosed cholecystitis were enrolled using consecutive sampling. During cholecystectomy, biopsy samples from both gastric and gallbladder mucosa were collected and examined for H. pylori presence using histological and immunohistochemical methods. Patient demographics and clinical history were also collected, and statistical analyses were conducted to evaluate associations between H. pylori infection and patient characteristics.
Results: H. pylori was found in the gastric mucosa of 53.2% of patients and in the gallbladder mucosa of 17.7%. Co-existence in both sites occurred in 12.1% of patients. Significant associations were noted between H. pylori presence in the gastric mucosa and factors like smoking status (p = 0.04) and BMI (p = 0.03). No significant link was observed between H. pylori presence and hypertension or diabetes.
Conclusion: The study shows distinct patterns of H. pylori localization in gastric and gallbladder mucosa among cholecystitis patients, with notable demographic associations. These results suggest a limited role for H. pylori in gallbladder diseases, emphasizing the need for targeted screening and treatment strategies in areas with high H. pylori prevalence.
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Dr Talal Safdar
Assistant Professor of Medicine, Fauji Foundation Hospital Rawalpindi, Pakistan
Dr Sana Afzal
MBBS, Lahore Medical and Dental College, Lahore, Pakistan
Dr Shabbir Ahmed
FCPS, Associate Professor of General Surgery, Bakhtawar Amin Medical College Multan General Surgery, Pakistan
Dr Moazama Shakeel Ahmed
House Officer, Department of Internal Medicine, King Edward Medical University/ Mayo Hospital, Pakistan
Dr Atiq Ahmad
MBBS, Post Graduate Resident Internal Medicine, Quaid-e-Azam Medical College Bahawalpur, Pakistan
Dr Abira Khan
House Officer, Department of Internal Medicine, Mayo Hospital Lahore, Pakistan