Background: Helicobacter pylori infection has been implicated in the pathogenesis of many gastrointestinal conditions. It has been found to occur more frequently in older patients, patients of lower socioeconomic status, and in developing countries.
Methods: We retrospectively reviewed the records of all patients who underwent upper endoscopies in 2005 and 2006 in a gastroenterology clinic, which primarily serves an indigent, inner-city population. We analyzed the data looking at the overall prevalence of H. pylori, the clinical symptoms at presentation, and the endoscopic findings.
Results: There were 248 upper endoscopic procedures performed over the two years. H. pylori infection was more common in the Hispanic population (40%) compared to the Caucasian (24%) and African-American populations (28%), (P < 0.001 and P = 0.024 respectively). Clinical predictors (e.g. dyspepsia, abdominal pain, and gastroesophageal reflux) were not associated with H. pylori positivity. Of the patients with gastroesophageal reflux, 75% did not have H. pylori infection (P = 0.202). Among patients who had the endoscopic appearance of gastritis, 46.7% had H. pylori infection (P < 0.001 vs patients without gastritis). Endoscopic evidence of gastric ulceration had a positive predictive value of 81.3% for H. pylori infection. Of the patients who had Barrett's esophagus, 89% were negative for H. pylori infection.
Conclusions: The overall prevalence of H. pylori infection in our study was 36.3%, similar to previously reported values. The association of H. pylori infection with certain endoscopic findings and race/ ethnicity argues that certain subsets of patients may benefit from having biopsies for H. pylori in all cases of endoscopic examination. There was a suggestion of a possible protective effect of H. pylori positivity against development of gastroesophageal reflux and Barrett's esophagus.