Chronic abdominal pain in Primary Care and the presence of Helicobacter pylori and parasites in stool.

A large number of Primary Care consultations are for chronic abdominal pain and heavy digestion, which can be related to infection with Helicobacter pylori and/or parasites in some patients (1,2). These are given an empiric therapy and/or their stool is examined for the presence of H. pylori and its treatment when detected (3). The prevalence of these parasites varies according to the socio-demographic setting, and they require specific detection and treatment (4). This study retrospectively analyses the prevalence of H. pylori and intestinal parasites in stool samples from Primary Care patients presenting with chronic abdominal pain. Between September 2010 and August 2013, 4,080 consecutive stool samples were studied; investigating the presence of H. pylori in 1240 samples from 1,240 patients and the presence of intestinal parasites in 2,840 stool samples from the same patients (who provided up to three samples each). Immunochromatography was used to detect antigens of H. pylori (5). Intestinal parasites were studied in concentrated stool specimens by observation under a microscope after staining with Lugol’s solution (6). Infection with Blastocystis hominis was defined by the presence of more than five forms per field. The presence of antigens of Cryptosporidium and Giardia was studied in 607 samples with a soft consistency or derived from immunodepressed patients, using immunochromatography (7) and visualization of the stool concentrate with acid alcohol-resistant staining. The chi-square test was used for statistical analysis of the results. Table I lists the results obtained. H. pylori was detected in 226 samples (22.3 %). Parasites were detected in 115 samples (4.05 %), comprising: Giardia lamblia (54.8 %), B. hominis (18.2 %), Cryptosporidium spp. (11.3 %), Ascaris lumbricoides (6.9 %), Enterobius vermicularis (4.3 %), Strongyloides stercolaris (1.7 %), Trichuris trichura, Hymenolepis nana, or uncinaria (0.9 %). Co-infection was observed in two samples: A. lumbricoides with T. trichura in one and Cryptosporidium spp. with G. lamblia in the other. Out of these samples with para-