Helicobacter pylori and dyspepsia from a public health perspective : The Sørreisa Gastrointestinal Disorder Study
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Anne Mette Asfeldt, Sonja Eriksson Steigen, Maja-Lisa Løchen, Bjørn Straume, Roar Johnsen, Bjørn Bernersen, Jon Florholmen, and Eyvind J. Paulssen: 'The natural course of Helicobacter pylori in gastritis, peptic ulcer disease and reflux oesophagitis in a population-based prospective cohort: The Sørreisa Gastrointestinal Disorder Study.' (Submitted version). Later published in European journal of epidemiology (2009) 24:649–658, available at http://dx.doi.org/10.1007/s10654-009-9371-6 (PDF)
Anne Mette Asfeldt, Bjørn Straume & Eyvind J. Paulssen: 'Impact of observer variability on the usefulness of endoscopic images for the documentation of upper gastrointestinal endoscopy.' Scandinavian Journal of Gastroenterology, 2007; 42: 1106-1112. © Taylor & Francis. Reprinted with permission. (PDF)
A. M. Asfeldt; M.-L. Loslashchen; B. Straume; S. E. Steigen; J. Florholmen; R. Goll; O. Nestegard and E. J. Paulssen: 'Accuracy of a monoclonal antibody-based stool antigen test in the diagnosis of Helicobacter pylori infection.' Scandinavian Journal of Gastroenterology, vol 39, no 11, November 2004, pages 1073 - 1077. © Taylor & Francis. Reprinted with permission. (PDF)
Thesis introduction (PDF)
Date
2009-04-24Type
Doctoral thesisDoktorgradsavhandling
Author
Asfeldt, Anne MetteAbstract
Dyspepsia is a highly prevalent condition, involving substantial health-care resources.
Ever since Marshall and Warren in 1984 discovered that Helicobacter pylori could cause peptic ulcer, it has been discussed to what extend Helicobacter pylori play a role in dyspepsia in general. In 2004 a population based survey was carried out in the municipality of Sørreisa, comprising a questionnaire survey on gastrointestinal disorders and upper endoscopy of a subgroup of the population. The results from this survey were compared with a similar survey in Sørreisa from 1987.
Main Results
A diagnostic test, the “Amplified IDEIA Hp StAR®” (DakoCytomation, Denmark) was validated and found to be very accurate, also in patients using proton pump inhibitors. The observer variability in upper endoscopy was studied and found to be considerable. A systematic image documentation of the endoscopy findings, regardless of suspicion of pathology, would improve the quality of the procedure. The prevalence of H. pylori has decreased considerably since 1987, whereas the prevalence of dyspepsia has remained constant, thus questioning any relationship between the two. Helicobacter pylori is only a moderate risk factor for peptic ulcer, whereas other risk factors as smoking seems to be just as important. Helicobacter pylori causes inflammation of the gastric mucosa, but plays a minor role in more chronic changes of the gastric mucosa such as atrophy and intestinal metaplasia. Elimination of Helicobacter pylori infection causes regression of inflammation, but not regression of intestinal metaplasia once it has developed.
The thesis emanate from the Department of Community and the department of Clinical Medicine, University of Tromsø, Norway
Main Results
A diagnostic test, the “Amplified IDEIA Hp StAR®” (DakoCytomation, Denmark) was validated and found to be very accurate, also in patients using proton pump inhibitors. The observer variability in upper endoscopy was studied and found to be considerable. A systematic image documentation of the endoscopy findings, regardless of suspicion of pathology, would improve the quality of the procedure. The prevalence of H. pylori has decreased considerably since 1987, whereas the prevalence of dyspepsia has remained constant, thus questioning any relationship between the two. Helicobacter pylori is only a moderate risk factor for peptic ulcer, whereas other risk factors as smoking seems to be just as important. Helicobacter pylori causes inflammation of the gastric mucosa, but plays a minor role in more chronic changes of the gastric mucosa such as atrophy and intestinal metaplasia. Elimination of Helicobacter pylori infection causes regression of inflammation, but not regression of intestinal metaplasia once it has developed.
The thesis emanate from the Department of Community and the department of Clinical Medicine, University of Tromsø, Norway
Description
Paper number 3 of the thesis is not available in Munin due to publisher's restrictions:
3. Anne Mette Asfeldt, Bjørn Straume, Sonja Eriksson Steigen, Maja-Lisa Løchen, Jon Florholmen, Bjørn Bernersen, Roar Johnsen, Eyvind J. Paulssen: 'Changes in the prevalence of dyspepsia and Helicobacter pylori infection after 17 years: The Sørreisa gastrointestinal disorder study' European journal of epidemiology (2008) 23:625–633 (Springer). Available at http://dx.doi.org/10.1007/s10654-008-9275-x
3. Anne Mette Asfeldt, Bjørn Straume, Sonja Eriksson Steigen, Maja-Lisa Løchen, Jon Florholmen, Bjørn Bernersen, Roar Johnsen, Eyvind J. Paulssen: 'Changes in the prevalence of dyspepsia and Helicobacter pylori infection after 17 years: The Sørreisa gastrointestinal disorder study' European journal of epidemiology (2008) 23:625–633 (Springer). Available at http://dx.doi.org/10.1007/s10654-008-9275-x
Publisher
Universitetet i TromsøUniversity of Tromsø
Series
ISM skriftserie, nr 103Metadata
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- Doktorgradsavhandlinger (Helsefak) [716]
- ISM skriftserie [161]
Copyright 2009 The Author(s)
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