Pervasive occult gastrointestinal bleeding in an Alaska native population with prevalent iron deficiency. Role of Helicobacter pylori gastritis.
JAMA
; 277(14): 1135-9, 1997 Apr 09.
Article
em En
| MEDLINE
| ID: mdl-9087468
ABSTRACT
OBJECTIVE:
To confirm prevalent iron deficiency among Yupik Eskimos living in Alaska and to explore the frequency of and potential lesions accounting for occult gastrointestinal bleeding.DESIGN:
Descriptive survey.SETTING:
Rural Arctic community.SUBJECTS:
A total of 140 adult volunteers from 3 villages in the Yukon-Kuskokwim Delta region of western Alaska. MAIN OUTCOMEMEASURES:
Daily iron intake, hematologic and biochemical indexes of iron status, fecal hemoglobin levels, stool parasites, and endoscopic findings.RESULTS:
While dietary iron intake by Yupiks was similar to that of a reference population, iron deficiency prevalence was increased 13-fold in Yupik men and 4-fold in Yupik women. Fecal hemoglobin levels were elevated in 90% of subjects contrasted with only 4% of a reference group; median levels were 5.9 and 0.5 mg of hemoglobin per gram of stool, respectively. Among 70 Yupik subjects with elevated fecal hemoglobin levels who had endoscopy performed, 68 (97%) had an abnormal gastric appearance consisting of erythema, mucosal thickening, diffuse mucosal hemorrhages, erosions, or ulcerations. Gastric biopsies revealed chronic active gastritis with associated Helicobacter pylori in 68 (99%) of 69. No other hemorrhagic gastrointestinal disease was detected.CONCLUSIONS:
Based on this study sample, occult gastrointestinal bleeding appears to be pervasive in the Yupik population and likely underlies the prevalent iron deficiency. An atypical hemorrhagic gastritis associated with H pylori infection is present almost universally and may represent the bleeding source.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Inuíte
/
Helicobacter pylori
/
Infecções por Helicobacter
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Gastrite
/
Deficiências de Ferro
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Hemorragia Gastrointestinal
Tipo de estudo:
Etiology_studies
/
Prevalence_studies
/
Risk_factors_studies
Limite:
Adult
/
Aged
/
Aged80
/
Female
/
Humans
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Male
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Middle aged
País/Região como assunto:
America do norte
Idioma:
En
Revista:
JAMA
Ano de publicação:
1997
Tipo de documento:
Article