Prevalence of Helicobacter pylori and Endoscopic and Histopathological Findings in Obese Patients who are Candidates for Bariatric Surgery

Abstract

Introduction. The prevalence of Helicobacter pylori in obese patients has been poorly documented, especially in contexts with adequate healthcare access. In these patients, the absence of visible lesions during endoscopy may lead to underestimate relevant histological alterations if systematic biopsies are not performed. There are few local studies characterizing this population, which motivates the need for this research.

Objective. To estimate the prevalence of Helicobacter pylori and to describe the endoscopic and histopathological findings, as well as sociodemographic variables, in obese patients who are candidates for bariatric surgery at the Hospital Universitario Austral.

Materials and methods. Observational, descriptive, cross-sectional, and retrospective study carried out on a cohort of patients who underwent bariatric surgery between 2022 and 2024. Those with complete esophagogastroduodenoscopy and gastric biopsies according to the Sydney protocol were included. Endoscopic findings, histopathological diagnosis, and the presence or absence of H. pylori in the patients were analyzed, stratified by sex and degree of obesity.

Results. Out of the 418 patients who underwent surgery in our institution, 326 (78%) with esophagogastroduodenoscopy with gastric biopsies were included in the analysis. The rest had esophagogastroduodenoscopy without biopsies, or had not undergone the procedure. Endoscopic lesions were identified in 60.1% of cases, the most frequent being gastric erosions (35.5%) and erosive esophagitis (18.1%). The histopathological analysis revealed chronic gastritis in 55.2% and Helicobacter pylori infection in 21.5%, even in the absence of macroscopic lesions. Significant differences by sex were observed in the prevalence of lesions and histological findings.

Conclusion. The systematic use of biopsies according to Sydney’s protocol allows the identification of relevant histological alterations in obese patients, even in the absence of apparent endoscopic lesions. It is important to perform systematic biopsies during preoperative evaluation to optimize the detection and timely treatment of associated gastrointestinal pathologies.