Pustaka Ilmiah Universitas Padjadjaran

Abstrak

he Prevalence of NSAID related ulcer and Helicobacter pylori related ulcer in Hasan Sadikin General Hospital Bandung Indonesia

Background:NSAID and Helicobacter pylori (Hp) are major causes of gastroduodenal ulcers.Previous study reported that prevalence of Hp in patient who took NSAID were lower than who did not take NSAID.The aim of this study are to compare the prevalence of Hp infection in patients with ulcer and non ulcer in those who took NSAID and did not take NSAID for their medication and to compare the proportion of NSAID related ulcer and Hp related ulcer inpatients with gastric ulcer(GU) and duodenal ulcer(DU).

Material and Methods:Between January 1995 and December 1996, a retrospective study was done to 162 patients who were proven to have ulcer and non ulcer by endoscopic examination.Patients were divided into NSAID user group and non NSAID user group based on their drug history.Infection of Hp were tested by CLO and histopathology.

Result and Conclusion:Between January 1995 and December 1996,162 patients were studied, they consisted of 64 patients with gastroduodenal ulcer(33 GU and 31 DU) and 98 patients without ulcer(NU).Age ranged from 16 to 78 years old, 84 patients were male and 78 patients were female.The median age of GU was 60 years, DU was 48 years and NU was 44 years.Among patients with ulcer,theprevalence of Hp infection was 6/40(15%) in NSAID users compare to 21/24 (87.5%) in non NSAID user(p<0.001).Among patients NU the prevalence of Hp infection was 13/39(33.3%) in NSAID users compare to 35/59(59.3%) in non NSAID user (p<0.05).There was no significant difference of Hp infection between ulcer group and NU group in patients who took NSAID(15% vs 33.3%;p>0.05). Significant difference of Hp infection was found in ulcer group and NU group in non NSAID user (87.5% vs 59.3%;p<0.05).Among patients with ulcer,34/64 (53.1%) were NSAID user without Hp infection and 21/64(38.1%) were non NSAID user with Hp infection(p<0.05).Among patients with GU,28/33(84.8%) were NSAID user without Hp infection and 2/33(6%)were non NSAID user with Hp infection (p<0.001). Conversely among patients with DU,6/31(19.4%) were NSAID user without infection and 19/31(61.3%) were non NSAID user with Hp infection (p<0.01).We therefore conclude that prevalence of Hp infection in patients with ulcer and without ulcer who took NSAID were lower than those who did not.The NSAID related ulcer was more frequent than Hp related ulcer.Gastric ulcers were found more frequent in patients with positive NSAID usage,but duodenal ulcers were found more frequent in patients with Hp infection.