Clinicohistopathological correlation and Helicobacter pylori status in patients with functional dyspepsia

Abstract

Background: Functional dyspepsia (FD) is a condition of immense clinical significance. Helicobacter pylori may be responsible for FD in a subset of patients. Materials and Methods: Upper gastrointestinal endoscopy was done in sixty patients of FD fulfilling ROME III criteria, and gastric and duodenal biopsies were taken. Duodenal histopathological findings and H. pylori status were correlated with the symptomatology. Standard treatment was given according to the H. pylori status, and the response was analyzed using 6-point Likert scale. Results: Sixty percent of cases were infected with H. pylori. 72.5% of cases with predominant epigastric pain were H. pylori-positive. 96.5% patients with early satiety had duodenal eosinophilia and duodenitis. Epigastric pain was significantly associated with H. pylori, and early satiety was associated with duodenal eosinophilia and duodenitis. Sixty-five percent of cases had increased duodenal intraepithelial lymphocyte count. 88.8% cases showing no response to treatment had duodenal eosinophilia. Conclusion: H. pylori infection constitutes an important subset of FD patients. H. pylori infection, duodenitis, and duodenal eosinophilia contribute to symptom generation. H. pylori eradication can provide symptomatic relief. A duodenal biopsy can identify an important subset of patients with duodenal eosinophilia and duodenitis which can be a contributor for poor treatment response and can be clinically amenable to new treatment avenues.