Purpose: About 27% of the US population and 50% of the world population is infected with HP. Uncontrolled case series and epidemiologic studies based on sero-prevalence rates suggest an association between HP infection and iron store depletion. The aim of this study was to investigate the association between HP and iron deficiency with/without anemia in an adult population with negative endoscopic findings. Methods: This was a retrospective review of patients undergoing upper gastrointestinal endoscopy at the Syracuse VA medical center from Jan 2000 to Feb 2003. CLO test and gastric biopsy results were noted in 600 consecutive patients. HP infection was defined by a positive CLO test and/or positive biopsy result. Patient demographics, medication use and alcohol consumption, laboratory data, and endoscopic findings were recorded. Patients with an identifiable cause of iron deficiency at EGD (179), colonoscopy (48) or both (16); celiac disease (3), and bowel surgery (1) were excluded. An additional 14 patients with repeat EGD and HP testing were omitted. Statistical Analysis: Iron deficiency anemia was defined as hemoglobin (Hb) <11.5 in females and Hb <12.5 in males, ferritin<30 and transferrin saturation <29%. Patient characteristics, laboratory data, and prevalence of iron deficiency anemia was compared in groups with and without HP by student t-test, chi-square and Fisher exact test. Results: 339 patients (68 HP positive and 271 HP negative) were included in the final analyses. The HP negative group had significantly more Caucasians and higher use of PPI (Table 1). Hb, serum ferritin level and prevalence of iron deficiency anemia in both groups was similar (Table 2).Table 1: Patient characteristics in groups with and without HPTable 2: Comparison of laboratory dataConclusions: In adults with negative endoscopic findings, H. pylori infection is not associated with iron deficiency.