Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Feb 13;17(1):27.
doi: 10.1186/s12876-017-0588-7.

Helicobacter pylori prevalence and clinical significance in patients with quiescent Crohn's disease

Adi Lahat  1   2 , Uri Kopylov  3   4 , Sandra Neuman  3   4 , Nina Levhar  3   4 , Doron Yablecovitch  3   4 , Benjamin Avidan  3   4 , Batia Weiss  4   5 , Shomron Ben-Horin  3   4 , Rami Eliakim  3   4 ; on behalf of the Israeli IBD research Network (IIRN)
Collaborators, Affiliations

Helicobacter pylori prevalence and clinical significance in patients with quiescent Crohn's disease

Adi Lahat et al. BMC Gastroenterol. .

Abstract

Background: Helicobacter pylori (HP) infection is present in about 50% of the global population, and is associated with chronic gastritis, peptic disease and gastric malignancies. HP prevalence in Crohn's disease (CD) patients was shown to be low compared to the general population, and its influence on disease activity is yet to be determined. Our aims were to determine the prevalence of HP in a selected group of CD patients with quiescent disease, and to assess the influence of its eradication on disease activity and endoscopic and laboratory activity measures.

Methods: Consecutive CD patients with quiescent disease underwent meticulous disease evaluation with MR enterography (MRE), video capsule endoscopy (VCE), CRP, fecal calprotectin and CDAI. All patients were tested for the presence of HP using stool antigen detection kit. Patients infected with HP were offered eradication treatment with sequential therapy. HP eradication was confirmed using urease breath test and stool antigen test. The influence of HP eradication on disease activity was assessed.

Results: Out of 56 patients enrolled, six patients (10.7%) had HP infection. Of them, five patients had gastro- duodenitis per VCE. All HP positive patients were offered eradication treatment and underwent successful eradication. Notably, 23 (50%) of patients had proximal disease per VCE, most of them (78%) were HP negative. CDAI, CRP, fecal calprotectin and VCE Lewis inflammatory score did not change significantly following HP eradication, Gastric findings on VCE were not impacted by HP eradication.

Conclusions: The prevalence of HP infection in patients with quiescent CD is relatively low. Eradication of the bacteria did not significantly change neither disease activity measures nor the presence of gastro- duodenitis per VCE, suggesting it might be part of proximal CD. The influence of HP on CD activity merits further investigation.

Keywords: Crohn’s disease; Eradication; Helicobacter pylori; Prevalence; Video capsule endoscopy.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Study design
Fig. 2
Fig. 2
Stomach inflammatory changes by VCE. a Gastric erosions (circled) prior to HP eradication. b Gastric erosions (circled) post HP eradication
Fig. 3
Fig. 3
Duodenum inflammatory changes by VCE0. a Erosion of proximal duodenum (circled) Prior to HP eradication. b Erosions in proximal duodenum (circled) Post HP eradication
See this image and copyright information in PMC

References

    1. World Gastroenterology Organisation Global Guidelines Helicobacter pylori in developing countries, August 2010. Available at: www.worldgastroenterology.org/UserFiles/file/guidelines/helicobacter-pyl.... last Accessed 10 Nov 2015
    1. Sonnenberg A. Review article: historic changes of Helicobacter pylori-associated diseases. Aliment Pharmacol Ther. 2013;38:329–342. doi: 10.1111/apt.12380. - DOI - PubMed
    1. Graham DY. History of Helicobacter pylori, duodenal ulcer, gastric ulcer and gastric cancer. World J Gastroenterol. 2014;20(18):5191–204. doi: 10.3748/wjg.v20.i18.5191. - DOI - PMC - PubMed
    1. Love JR, Irvine EJ, Fedorak RN. Quality of life in IBD. J Clinical Gastroenterol. 1992;14:15–19. doi: 10.1097/00004836-199201000-00005. - DOI - PubMed
    1. Casellas F, Arenas JI, Baudet JS, Fábregas S, García N, Gelabert J, et al. Impairment of health-related quality of life in patients with inflammatory bowel disease: a Spanish multicenter study. Inflamm Bowel Dis. 2005;11:488–496. doi: 10.1097/01.MIB.0000159661.55028.56. - DOI - PubMed

MeSH terms