Abstract
Introduction Dyspepsia is a common gastrointestinal (GI) complaint affecting a significant portion of the Indian population and is often associated with Helicobacter pylori infection. The clinical presentation alone may be insufficient to predict infection, necessitating a more comprehensive diagnostic approach. This study aimed to evaluate the association between H. pylori and dyspepsia, and to assess the related gastroduodenal pathologies using endoscopic and histopathological evaluations. Methods This cross-sectional study included 92 adult patients presenting with clinical symptoms of dyspepsia at a tertiary care hospital in central India from November 2022 to January 2024. All patients underwent upper gastrointestinal endoscopy and rapid urease test (RUT) for H. pylori detection. Biopsies were sent for histopathological analysis. Clinical, endoscopic, and histopathological findings were analyzed and compared between H. pylori-positive and H. pylori-negative groups using appropriate statistical tests. Results Helicobacter pylori infection was detected in 44 (47.8%) patients by RUT. Epigastric pain (76.1%) was the most prevalent symptom, although no significant association was found between clinical symptoms and H. pylori status (p > 0.05). Gastritis (72.8%) was the most common endoscopic finding, with a significant association between gastric ulcer and H. pylori positivity (p = 0.0368). Histopathological examination showed chronic inflammation in 12% of RUT-positive patients, which was statistically significant (p = 0.0346). Ultrasonographic findings did not show any significant correlation with H. pylori infection. Conclusion This study highlights the limited diagnostic value of symptoms alone in identifying H. pylori infection among dyspeptic patients. The findings support the routine use of endoscopic and histopathological evaluation in dyspepsia workup. Region-specific data such as this can aid in formulating more effective and individualized diagnostic and therapeutic strategies for dyspepsia management in Indian clinical settings.