Helicobacter pylori is Associated with Less Fistulizing, Stricturing, and Active Colitis in Crohn's Disease Patients

Area of Science:

• Gastroenterology
• Microbiology
• Immunology

Background:

• A potential protective role of Helicobacter pylori (HP) infection against Crohn's disease (CD) development has been suggested.
• Limited research exists on the association between HP infection and specific CD clinical phenotypes or disease activity.

Purpose of the Study:

• To investigate the clinical features and disease activity in Crohn's disease patients diagnosed with HP infection.
• To evaluate the association between HP infection and CD phenotypes such as strictures, fistulas, and active colitis.

Main Methods:

• Retrospective review of 306 patients from an inflammatory bowel disease database.
• Analysis of 91 Crohn's disease patients tested for HP infection, examining frequencies of strictures, fistulas, and colitis in surveillance biopsies.

Main Results:

• Of 91 CD patients tested, 19 had HP infection.
• HP infection was significantly associated with less fistulizing/stricturing disease (21.1% vs. 55.6%, p=0.009) and less active colitis (42.1% vs. 77.1%, p=0.005) in univariate analysis.
• Multivariate analysis confirmed HP infection as a protective factor for fistulizing/stricturing disease (OR: 0.22) and active colitis (OR: 0.186).

Conclusions:

• Helicobacter pylori infection is independently associated with a reduced prevalence of fistulizing/stricturing disease and active colitis in Crohn's disease patients.
• CD patients with a history of HP infection appear less prone to developing disease complications.