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The prevalence of Helicobacter pylori infection in inflammatory bowel disease in China: A case-control study
Zhao-Hui Ding1, Xiao-Ping Xu2, Tian-Rong Wang1
1Division of Gastroenterology and Hepatology, Shanghai Institute of Digestive Disease, Key Laboratory of Gastroenterology & Hepatology, Ministry of Health, RenJi Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Insights
Helicobacter pylori (H. pylori) infection is less common in patients with inflammatory bowel disease (IBD), particularly Crohn's disease (CD). This study found a significant negative association between H. pylori and IBD prevalence.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Epidemiology
Background:
- Inflammatory bowel disease (IBD) incidence is rising in China, where Helicobacter pylori (H. pylori) infection rates remain high.
- The relationship between H. pylori infection and IBD, including Crohn's disease (CD) and ulcerative colitis (UC), requires investigation.
Purpose of the Study:
- To investigate the association between H. pylori infection prevalence and inflammatory bowel disease (IBD).
Main Methods:
- A case-control study comparing hospitalized IBD patients (CD and UC) with age- and sex-matched healthy controls.
- H. pylori antibody testing was performed. Disease activity was assessed using standardized indices (Mayo Clinic score, Harvey-Bradshaw index).
- Exclusion criteria included prior H. pylori eradication therapy.
Main Results:
- The prevalence of H. pylori infection was significantly lower in IBD patients (9.6%) compared to controls (29.8%) (p < 2.796*10-10).
- This inverse association was particularly pronounced in Crohn's disease (CD) patients (8.9%) versus controls (p < 5.723*10-9).
- No significant differences were observed in H. pylori prevalence among UC patients, newly diagnosed IBD patients, or based on disease activity or treatment history.
Conclusions:
- H. pylori infection demonstrates a negative association with inflammatory bowel disease (IBD).
- The inverse relationship is especially notable for Crohn's disease (CD).
Background & Aims:
Helicobacter 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.
Methods:
Hospitalized 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.
Results:
Two 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.
Conclusions:
H. pylori infection had a negative association with IBD, especially CD.
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