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. 2018 Nov 6;6(13):641-649.
doi: 10.12998/wjcc.v6.i13.641.

Helicobacter pylori may be an initiating factor in newly diagnosed ulcerative colitis patients: A pilot study

Loai Mansour  1 , Ferial El-Kalla  1 , Abdelrahman Kobtan  1 , Sherief Abd-Elsalam  2 , Mohamed Yousef  1 , Samah Soliman  1 , Lobna Abo Ali  1 , Walaa Elkhalawany  1 , Ibrahim Amer  3 , Heba Harras  4 , Maha M Hagras  5 , Mohamed Elhendawy  1
Affiliations

Helicobacter pylori may be an initiating factor in newly diagnosed ulcerative colitis patients: A pilot study

Loai Mansour et al. World J Clin Cases. .

Abstract

Aim: To directly visualize Helicobacter pylori (H. pylori) by the highly sensitive and specific technique of immunohistochemical staining in colonic tissue from patients newly diagnosed with ulcerative colitis (UC).

Methods: Colonoscopic biopsies from thirty patients with newly diagnosed UC and thirty controls were stained with Giemsa stain and immunohistochemical stain for detection of H. pylori in the colonic tissue. Results were confirmed by testing H. pylori Ag in the stool then infected patients were randomized to receive either anti H. pylori treatment or placebo.

Results: Twelve/30 (40%) of the UC patients were positive for H. pylori by Giemsa, and 17/30 (56.6%) by immunohistochemistry stain. Among the control group 4/30 (13.3%) and 6/30 (20 %) were positive for H. pylori by Giemsa and immunohistochemistry staining respectively. H. pylori was significantly higher in UC than in controls (P = 0.04 and 0.007). All Giemsa positive patients and controls were positive by immunohistochemical stain. Four cases of the control group positive for H. pylori also showed microscopic features consistent with early UC.

Conclusion: H. pylori can be detected in colonic mucosa of patients with UC and patients with histological superficial ulcerations and mild infiltration consistent with early UC. There seems to be an association between UC and presence of H. pylori in the colonic tissue. Whether this is a causal relationship or not remains to be discovered.

Keywords: Giemsa stain; Helicobacter pylori; Immunohistochemical staining; Inflammatory bowel disease; Ulcerative colitis.

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Conflict of interest statement

Conflict-of-interest statement: The authors declare that they do not have any conflict of interest.

Figures

Figure 1
Figure 1
Study analysis population. H. pylori: Helicobacter pylori.
Figure 2
Figure 2
Demonstrates diffuse mononuclear inflammatory infiltrate in lamina propria and neutrophilic infiltration of the intestinal mucosa with ulceration of the surface epithelium as early changes of ulcerative colitis (HE: × 200).
Figure 3
Figure 3
Giemsa staining of the previous case showing Helicobacter pylori positive rod shape organisms (Giemsa stain: × 1000).
Figure 4
Figure 4
Ulcerative colitis showing crypt abscess and diffuse mononuclear inflammatory infiltrate in lamina propria with eosinophilia (HE: × 400).
Figure 5
Figure 5
Immunoperoxidase staining showing Helicobacter pylori positive organisms stained brown in color (immunoperoxidase stain: × 1000).
See this image and copyright information in PMC

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