Prevalence of Helicobacter pylori Infection in Korean Patients with Inflammatory Bowel Disease

Abstract

Purpose: The incidence of H.pylori infection was reported to be lower in individuals with inflammatory bowel disease (IBD) than in the normal populations of some western countries. In Korean populations, the prevalence of H.pylori infection is high and IBD is relatively uncommon. The aim of this study was to assess the prevalence of H.pylori infection in Korean patients with IBD. Another aim of the study was to assess the possible effect of drug therapy and phenotypic characteristics on the infection of H.pylori. Methods: We studied 97(mean age 40.1 years, range 13–78) unselected patients with IBD, including 63 with ulcerative colitis(UC) and 34 with Crohn's disease(CD). 270 healthy age- and sex matched subjects(mean age 41.3 years, range 16–80) served as controls. Infection rates of H.pylori were compaired between IBD patients(97) and the control groups(270). The relationship between drug therapy and the phenotypic characteristics and the prevalence of H.pylori infection were also analyzed. Results: Concerning positivity for H.pylori infection, significant differences between patients with IBD(54.1%) and controls(28.9%; P < 0.001), but not between patients with UC(34.9%) and CD(17.6%; P= 0.14) were noticed. When analyzed by age, the 15 to 29-year age group(P= 0.002) and the 30 to 44-year age group(P= 0.010) had a significantly different positive rate from that in the control group. The history of any drug therapy had no influence on H.pylori status in patients with CD. Among the previous therapies in patients with UC, steroid(P= 0.012) and ciprofloxacin(P= 0.027) were significantly related to lower incidence of H.pylori infecion. The prevalence of H.pylori infection among patients with CD was not related to phenotypic characteristics such as age, location and behavior of disease. Conclusions: Our observations confirm the low prevalence of H.pylori infection in patients with IBD. Difference of H.pylori positivity between the ranges of age may indicate the H.pylori infection influence differently on the bimodal peak age of onset of IBD. Association between H.pylori status and use of steroid and ciprofloxacin in patients with UC was noticed, suggesting that prevalence of H.pylori infection may be inversely correlated with the severity of disease.