Interaction between Helicobacter pylori and non-steroidal anti-inflammatory drugs in peptic ulcer bleeding.
BACKGROUND
Helicobacter pylori and non-steroidal anti-inflammatory drugs (NSAIDs) are the two primary causes of peptic ulcer disease. How H. pylori and NSAIDs interact and influence the development of ulcer bleeding is still not clear.


METHODS
A hospital-based, age- and sex-matched case-control study was conducted. Multivariate and stratified analyses were performed for further evaluation of the interaction between H. pylori and NSAIDs.


RESULTS
Ninety-seven patients (52 gastric ulcers, 45 duodenal ulcers) and 97 non-ulcer controls were enrolled in the study. H. pylori and NSAIDs were both found to be independent risk factors for ulcer bleeding (H. pylori odds ratio, 2.22; 95% confidence interval (CI), 1.23-4.01; NSAIDs odds ratio, 4.57; 95% CI, 2.50-8.35). There was no synergistic effect. In contrast, a negative interaction was observed in the logistic regression and stratified analysis, although the difference was not significant (H. pylori adjusted odds ratio, 3.47; 95% CI, 1.73-6.95; NSAID adjusted odds ratio, 6.16; 95% CI, 3.14-12.09).


CONCLUSIONS
H. pylori increases the risk of peptic ulcer bleeding but may play a protective role in NSAID users.
Wu
C Y
CY
Dept. of Internal Medicine, Taichung Veterans General Hospital, Taiwan.
Poon
S K
SK
Chen
G H
GH
Chang
C S
CS
Yeh
H Z
HZ
D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D016022:Case-Control Studies; D005260:Female; D016481:Helicobacter Infections / Q000150:complications* / Q000453:epidemiology; D016480:Helicobacter pylori; D006801:Humans; D016015:Logistic Models; D008297:Male; D010438:Peptic Ulcer Hemorrhage / Q000453:epidemiology / Q000209:etiology*; D015995:Prevalence; D012307:Risk Factors
D000894:Anti-Inflammatory Agents, Non-Steroidal