Abstract
BACKGROUND: Duodenal ulcers are strongly linked to a Gram-negative, urease-producing bacterium Helicobacter pylori (H. pylori) infection. Despite significant global research, there is a notable gap in regional studies detailing its prevalence and clinical patterns in South India, particularly Chennai. With growing antibiotic resistance and the influence of lifestyle factors, understanding the epidemiology of H. pylori infection becomes crucial for managing the disease successfully. AIM: To determine the prevalence of H. pylori infection among patients diagnosed with duodenal ulcers at a tertiary care hospital in Chennai, India. METHODS: A cross-sectional study was performed over one year at Sree Balaji Medical College and Hospital in Chennai. It included 112 patients diagnosed with duodenal ulcers via endoscopy. H. pylori detection involved multiple methods: biopsies obtained during upper gastrointestinal (UGI) endoscopy were subjected to histopathology and rapid urea test (RUT), while patients also underwent stool antigen test and urea breath test. Data encompassing clinical characteristics, risk factors, hygiene practices, and treatment protocols were collected via structured interviews and analyzed with Statistical Product and Service Solutions (SPSS, version 25.0; IBM SPSS Statistics for Windows, Armonk, NY). RESULTS: Overall prevalence of H. pylori among duodenal ulcer patients was 78 patients (69.6%). Infection rates were the highest in the 31-50 year age group and were slightly higher among females, which was 36 in total (72%), than the 42 males (67.7%). Significant associations were identified in H. pylori infection and risk factors such as smoking, alcohol use, high-salt diet, nonsteroidal anti-inflammatory drug (NSAID) use, poor hygiene practices, and a family history of peptic ulcer disease. Histopathology was the most accurate diagnostic method, showing 100% sensitivity and specificity. Quadruple therapy resulted in a higher eradication rate, which was for 26 patients out of 28 patients (92.9%). A lower six-month ulcer recurrence in two patients (7.1%) compared to triple therapy (76.0% eradication; 24.0% recurrence) was significantly evident. Adverse effects were more common with quadruple therapy but were manageable. Complications such as gastrointestinal bleeding and longer hospital stays were considerably more prevalent among H. pylori-positive patients. CONCLUSION: This research highlights the high burden of H. pylori among duodenal ulcer patients in Chennai. Regional risk factors, including diet, hygiene, and medication use, contribute significantly to infection prevalence. Quadruple therapy showed superior efficacy in the eradication and prevention of recurrence. These findings support the need for routine screening, region-specific treatment protocols, and targeted public health interventions to control H. pylori-related gastroduodenal disease.