Helicobacter pylori (H. pylori) is a bacterium found in the stomach and duodenum. It can cause mild chronic inflammation of the gastric mucosa, or even lead to gastric and duodenal ulcers or gastric cancer. About 30% - 50% of the world population is estimated to have detectable H. pylori in their gastrointestinal tract. Most individuals infected with H. pylori have few or no symptoms. They may experience a few episodes of gastritis (minor belching, bloating, nausea, vomiting, abdominal discomfort). Accurate and simple tests for the detection of H. pylori infection are available. They include blood antibody tests, urea breath tests, stool antigen tests, and endoscopic biopsies. Once H. pylori is detected in a person, a course of eradication treatment consisting of proton pump inhibitors and the antibiotics will be prescribed. About ninety percent of those who take on the full course of treatment are cured.

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Upper gastrointestinal endoscopy

Helicobacter Pylori Serology Test

Urea Breath Test (UBT)

Peptic ulcer disease (PUD) is a common disease of the digestive system. It usually occurs in the stomach and proximal duodenum. The lifetime risk for developing a peptic ulcer is approximately 10%. Peptic ulcer disease is caused by a bacterial infection (Helicobacter pylori) in the stomach or the use of certain painkillers (nonsteroidal anti-inflammtory drugs - NSAIDs) and aspirin/ other anti-platelet agents. Patients with peptic ulcer can be asymptomatic. If symptoms occur, they may include a burning pain in the middle or upper stomach between meals or at night, bloating, heartburn, nausea or vomiting. In severe cases, symptoms can include hematemesis, coffee ground vomiting and melena, weight loss, severe pain in the mid to upper abdomen. Individuals with PUD are at risk of developing complications such as haemorrhage, perforation and obstruction, and mortality among patients with these complications is high. Oesophagogastroduodenoscopy (OGD) is the preferred diagnostic test in the evaluation of patients with suspected PUD.

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Upper gastrointestinal endoscopy

Acute upper gastrointestinal bleeding (UGIB) is a common medical emergency with an annual incidence of approximately 130 per 100,000 adults in Hong Kong. Acute gastrointestinal (GI) bleeding is a potentially life-threatening condition associated with high morbidity and mortality. Bleeding may occur throughout the GI tract. The most frequent cause of UGIB is peptic ulcer disease, which accounts for 35-50% of reported cases. Other underlying etiologies of UGIB include gastroduodenal erosions (8-15%), esophagitis (5-15%), varices (5-10%), Mallory-Weiss tears (15%), and vascular malformations (5%).

Symptoms of upper gastrointestinal bleeding are hematemesis, coffee ground vomiting and tarry stool. In some severe cases, it may lead to dealth.

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Upper gastrointestinal endoscopy

Stomach cancer is developed due to the abnormal proliferation of mucosal cells on the inside lining of the stomach (adenocarcinoma). Gastric adenocarcinoma is the most common type of stomach cancer, commonly known as "stomach cancer." Initially gastric mucosa may be due to inflammation, into atrophic gastritis, intestinal metaplasia , after years of progress to the abnormal proliferation of cells , and finally develop to cancer, which is a series of long-term " carcinogenic " evolution. Gastric cancer ranks the forth most common cancer-related cause of mortality in Hong Kong.

Although a gradual declining trend is observed in Europe and the United States, the incidence of stomach cancer remains rather steady in Asia. Major risk factors for gastric cancer include "H. pylori" infection, precancerous lesions or genetic factors of gastric cancer.

Patients with early gastric cancer do not have associated symptoms. It shares similar symptoms with other gastric diseases (chronic gastritis , peptic ulcer, or other symptoms of functional gastrointestinal disorders) such as: abdominal pain, flatulence , poor appetite, melena , etc. Patients having end stage of stomach cancer may also suffer from weight loss, loss of appetite , fatigue , difficulty swallowing, persistent vomiting , massive ascites and other advanced symptoms . Gastric cancer is mainly diagnosed by Oesophagogastroduodenoscopy and biopsy histopathology.

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Upper gastrointestinal endoscopy