Helicobacter pylori Infection in Five Inpatient Units for People with Intellectual Disability and Psychiatric Disorder

Abstract

Background A high prevalence of Helicobacter pylori infection has been reported among people with intellectual disability, especially those residing in hospital and similar settings. Surveys of inpatients have found unusually high rates of gastrointestinal malignancy, to which H. pylori infection predisposes.Methods Helicobacter pylori antibody testing was arranged for all residents of five inpatient units for people with intellectual disability and challenging behaviour or psychiatric disorder. Eradication triple therapy was prescribed for those people with a positive result. 13C urea breath testing was attempted after eradication therapy.Results Thirty‐seven residents were identified. It was possible to obtain blood for H. pylori antibody testing for 36 people. Twenty‐two (59%) had a positive result. Dividing the people studied according to length of stay in hospital showed that 4 of the 18 people resident in hospital for <4 years (22%) had a positive antibody test, compared with 16 of the 19 people resident in hospital for ≥4 years (84%; χ2 = 14.6; P < 0.001). Treatment led to eradication of H. pylori infection in 11 of the 12 people who were able to cooperate with testing.Conclusions Clinicians should have a high index of suspicion for H. pylori infection among people with intellectual disability who have a history of institutional care or prolonged hospital admission, especially those who have spent more than 4 years in such settings. Testing for H. pylori antibodies is well tolerated. Eradication therapy offers many health benefits, including a reduction of the risk for stomach malignancies.