Helicobacter Pylori Infection

The incidence of infection with H. Pylori has been noted to be between 22 and 67 % [5]. Although most surgeons would prefer eradicating H. pylori prior to RYGB on the basis of inaccessibility to the gastric remnant, the role of H. pylori in the pathogenesis of MU is still inconclusive [37]. A few studies have shown a positive association of H. pylori to MU [16, 38, 39]. But a recent study from Rawlins et al. did not show any difference in the rate of complications between patients with and without H.pylori [40]. Similar results have been shown by many other authors [17, 41, 42]. It was also noted that H. pylori infection was associated with higher incidence of foregut symptoms and eradication of this had resolved these symptoms in most patients [43]. This is probably related to the bacteria related inflammation [44].

Other Factors

Hypertension was shown to be risk factor for development of MU in one study [30]. With regard to presence of DM, although one study showed an association, most others did not [7, 10, 16, 26, 36, 42]. No study has shown an association between alcohol and MU [15]. In one study it was noted that patients with history of gastroesophageal reflux disease (GERD) before surgery had a higher incidence of MU’s compared to patients without GERD [45].

 
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