Abstract

Background & aimsHelicobacter pylori (H. pylori) infection remains high in China though the incidence of inflammatory bowel disease (IBD) has increased. Our aim was to investigate the relationship between the prevalence of H. pylori and inflammatory bowel disease.MethodsHospitalized IBD patients including Crohn’s disease (CD) and ulcerative colitis (UC) who had tested H. pylori antibody were enrolled. Controls were chose from age- and sex- matched healthy physical examination people who had H. pylori antibody test in a 1:2 fashion (IBD patients:controls). IBD medical history was recorded. All patients were typed by the Montreal classification. Mayo Clinic score and the Harvey-Bradshaw Severity Index were used to evaluate their disease activity. Patients and controls that had H. pylori eradication therapy before were excluded.ResultsTwo hundred and sixty IBD patients including 213 CD patients and 47 UC patients, and 520 controls were involved in this study. The prevalence of H. pylori infection in IBD patients (9.6%, 25/260) and IBD newly diagnosed patients (12.1%, 8/66), as well as CD patients (8.9%, 19/213) including CD newly diagnosed patients (10.6%, 5/47) and UC patients (12.8%, 6/47) was significantly lower than controls (29.8%, 155/520) (p = 2.796*10−10, 0.007, 5.723*10−9, 0.016, 0.014), while there was no statistically difference between UC newly diagnosed patients and the controls, and IBD patients with different disease type, disease activity and treatment history.ConclusionsH. pylori infection had a negative association with IBD, especially CD.

Highlights

  • Helicobacter pylori (H. pylori), a common Gram-negative, gastric mucosa colonized microaerobic bacteria, classified as a Class I carcinogen by the World Health Organization, can cause infectious disease and is associated with peptic ulcers, gastric cancer and MALT lymphoma

  • The prevalence of H. pylori infection in inflammatory bowel disease (IBD) patients (9.6%, 25/260) and IBD newly diagnosed patients (12.1%, 8/66), as well as Crohn’s disease (CD) patients (8.9%, 19/213) including CD newly diagnosed patients (10.6%, 5/47) and ulcerative colitis (UC) patients (12.8%, 6/47) was significantly lower than controls (29.8%, 155/520) (p = 2.796*10−10, 0.007, 5.723*10−9, 0.016, 0.014), while there was no statistically difference between UC newly diagnosed patients and the controls, and IBD patients with different disease type, disease activity and treatment history

  • H. pylori infection had a negative association with IBD, especially CD

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Summary

Introduction

Helicobacter pylori (H. pylori), a common Gram-negative, gastric mucosa colonized microaerobic bacteria, classified as a Class I carcinogen by the World Health Organization, can cause infectious disease and is associated with peptic ulcers, gastric cancer and MALT lymphoma. Some epidemiology studies from Western believed that H. pylori infection was a protective factor for IBD [5] and some animal studies showed the protective effects of H. pylori in colitis [6]. Other researchers such as Bell et al didn’t identify any Helicobactor species in the colonic biopsies of IBD patients by multiple polymerase chain reactions (PCR) and indicated that it was not related to the occurrence of IBD [7]. Our aim is to study the relationship between H. pylori status and IBD patients in China

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