Dyspepsia syndrome in the practice of a primary care physician: clinical and morphological associations

Aim: to present the morphological characteristics of changes in the gastric mucosa in patients with dyspepsia syndrome. Materials and methods: The study included 262 patients (men - 25.6%, n=67; women - 74.4%, n=195), the median age was 57 (45;64) years. The results of laboratory and instrumental studies, clinical and anamnestic data were studied. In all cases, a biopsy was taken according to the standard of five points (two biopsies from the antrum of the stomach, two biopsies from the stomach body, one from the corner of the stomach) to verify the grade of inflammation, stage of gastritis and diagnosis of H. pylori status. Results: The study showed that in patients aged 57 (45;64) years with dyspeptic complaints at the stage of primary health care, the predominant variant of dyspepsia was epigastric pain syndrome. All patients with dyspepsia syndrome had signs of chronic gastritis. According to histobacterioscopy, grade III or IV inflammation was more often registered in patients with H. pylori-positive gastritis (78.6% vs. 30.8% in patients with H. pylori - negative gastritis, p<0.001). In patients with H. pylori - negative gastritis the stage of atrophy was higher (stage III or IV was registered in 18.5% of patients vs. 7.1% in patients with H. pylori negative gastritis, p<0.001). To clarify the etiology of gastritis, in case of a negative result of histobacterioscopy for H. pylori, it is advisable to confirm the absence of H. pylori by the second method using a respiratory urease test C13 or detection of H.pylori antigen in feces or a test for antibodies in the blood to H. pylori; exclude the persistence of immune inflammation due to genetic predisposition in previously infected persons; exclude other, rarer etiological forms of gastritis.

H. pylori infection, dyspepsia, chronic gastritis, inflammation of the gastric lining

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