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Helicobacter pylori and Crohn's disease: a retrospective single-center study from China
Zun Xiang1, Yi-Peng Chen, Yue-Fang Ye
1Department of Gastroenterology, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China.
Insights
Lower rates of Helicobacter pylori (H. pylori) infection were observed in Crohn
Area of Science:
- Gastroenterology
- Microbiology
- Immunology
Background:
- Crohn's disease (CD) is a chronic inflammatory bowel disease with complex etiology.
- Helicobacter pylori (H. pylori) is a common bacterial pathogen affecting the upper gastrointestinal tract.
- The relationship between H. pylori infection and CD prevalence remains incompletely understood.
Purpose of the Study:
- To investigate the association between H. pylori infection and the prevalence of Crohn's disease.
- To compare H. pylori infection rates in CD patients versus a control group.
- To analyze H. pylori infection rates based on CD extent and severity.
Main Methods:
- Retrospective analysis of 447 patients with gastrointestinal symptoms.
- CD diagnosis confirmed by endoscopy and biopsy.
- H. pylori infection assessed via (14)C-urea breath test and biopsy culture.
Main Results:
- The H. pylori infection rate was significantly lower in CD patients (27.1%) compared to controls (47.9%).
- Lower H. pylori prevalence was noted across various extents (colonic, small intestine, ileocolonic, extensive) and severities (remission, moderate, severe) of CD.
- CD patients exhibited higher rates of smoking, alcohol intake, elevated white blood cell counts, and C-reactive protein, with lower BMI compared to controls.
Conclusions:
- The reduced prevalence of H. pylori infection in CD patients suggests a potential inverse correlation.
- These findings indicate a possible protective role or altered susceptibility related to H. pylori in CD.
- Caution is advised regarding H. pylori eradication strategies in CD patients due to this observed association.
Aim:
To investigate the association between Helicobacter pylori (H. pylori) infection and the prevalence of Crohn's disease (CD).
Methods:
Subjects were selected from patients admitted the gastrointestinal (GI) department at The First Affiliated Hospital School of Medicine (Zhejiang University) for abdominal pain, hematochezia, diarrhea and other GI symptoms between January 2008 and September 2012. CD was diagnosed by endoscopy and biopsy. H. pylori infection was detected by a (14)C-urea breath test and culturing of the biopsy sample. Demographic, anthropometric and serologic data were collected for each patient. H. pylori infection rate was compared between CD and control groups, followed by a subgroup analysis based on extent and severity of CD. Student's t, Mann-Whiney U, and χ(2) tests were used to analyze the data.
Results:
A total of 447 patients were analyzed, including 229 in the CD group and 248 in the control group. There were no significant differences in age, sex, and rates of hypertension or diabetes. However, the CD group showed significantly higher rates of smoking history (34.9% vs 18.1%), alcohol intake (17.4% vs 8.1%), white blood cell count (9.7 ± 2.9 × 10(9)/L vs 4.3 ± 0.9 × 10(9)/L), and C-reactive protein (36.3 ± 20.8 mg/L vs 5.5 ± 2.3 mg/L) but lower body mass index (24.5 ± 2.0 kg/m(2) vs 26.0 ± 2.2 kg/m(2)) than the control group. The H. pylori infection rate in the CD group was 27.1%, significantly lower than that of 47.9% in the control group. Furthermore, the H. pylori infection rates in patients with colonic, small intestine, ileocolonic and extensive CD were 31.1%, 28.9%, 26.8% and 25.9% respectively, all of which were significantly lower than in the control group. Finally, the H. pylori infection rates in patients with remission, moderate and severe CD were 34.3%, 30.7% and 22.0% respectively, which were also significantly lower than in the control group.
Conclusion:
Lower H. pylori infection in CD patients suggests a correlation between bacterial infection and CD, suggesting caution when considering H. pylori eradication in CD patients.
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