Prevalence and histopathological features of Helicobacter pylori infection among patients undergoing upper endoscopy in Zakho City, Iraq during 2021–2023

Background: The prevalence of Helicobacter pylori infection varies worldwide and is associated with gastrointestinal diseases. Helicobacter pylori prevalence varies globally and is linked to gastrointestinal diseases. This study examines the prevalence and histopathological features of H. pylori among outpatients undergoing upper endoscopy in Zakho, Iraq, from 2021 to 2023. Methods: This retrospective cross-sectional study was conducted between 2021 and 2023 in Zakho, Iraq. A total of 183 patients aged 16 to 75 years were diagnosed based on endoscopic biopsy and specimens obtained from the antrum and body of the stomach. A microscopic examination was performed following histopathological specimen preparation to detect H. pylori and analyze histopathological findings. Results: Among 183 patients who underwent endoscopy, H. pylori infection was found in 128 (69.94%). The most common symptoms were epigastric pain 55 (30.05%), burning sensation 41 (22.4%), and nausea 33 (18.03%), Only regurgitation showed a significant difference (p = 0.023). Common endoscopic findings included pangastritis 51 (27.87%, p = 0.01), erosive gastritis 40 (21.85%), gastric ulcers 31 (16.93%, p = 0.01), and duodenal ulcers 22 (12.02%, p = 0.003). Histopathologically, ulceration/erosion 127 (69.3%, p = 0.01) and lymphoepithelial lesions (20.76%, p = 0.001) were significantly more frequent in H. pylori-positive patients. Conclusion: This study revealed a high prevalence of H. pylori, strongly linked to ulceration, erosion, pangastritis, and erosive gastritis. The findings highlight the need for region-specific management guidelines to improve treatment and public health strategies in Zakho.