Assessment of the prevalence of infection with Helicobacter pylori in patients with inflammatory bowel disease.
OBJECTIVE
To determine the prevalence of Helicobacter pylori in patients with inflammatory bowel disease (IBD) and compare this to the prevalence in a control population with non-organic bowel symptoms, and to investigate the effect of sulphasalazine and other 5-aminosalicylic acid (5-ASA) drugs on the prevalence of H. pylori in IBD patients.


METHODS
Prospective, controlled trial.


METHODS
Gastroenterology out-patient department, City General Hospital, North Staffordshire Hospitals NHS Trust, Stoke-on-Trent.


METHODS
The population comprised 51 patients with ulcerative colitis, 42 patients with Crohn's disease and 40 patients with irritable bowel syndrome as controls. Patients with X-ray- and/or biopsy-proven disease were eligible to be entered into the study.


METHODS
Subjects filled in a detailed questionnaire, were assessed for seropositivity of H. pylori and underwent a C13 urea breath test (UBT).


METHODS
Seropositivity for H. pylori and a positive C13 UBT result.


RESULTS
A quarter of the irritable bowel syndrome controls were seropositive for H. pylori. Of the ulcerative colitis patients, 21.6% were currently H. pylori-positive on C13 UBT; 17.6% of the ulcerative colitis patients who had been previously treated with sulphasalazine were positive while 23.1% of the ulcerative colitis patients who had been treated with a non-sulphasalazine 5-ASA drug were positive. Of the Crohn's patients, 11.9% were currently H. pylori-positive; 3.6% of the Crohn's patients who had been previously treated with sulphasalazine were positive while 12.5% of the Crohn's patients who had been treated with a non-sulphasalazine 5-ASA drug were positive.


CONCLUSIONS
Patients with IBD and Crohn's disease in particular were less likely to be H. pylori-positive than controls. Sulphasalazine treatment further decreased the prevalence of H. pylori, although the reduced prevalence of H. pylori in IBD patients could not be accounted for by this alone.
Pearce
C B
CB
Department of Gastroenterology, Queen Alexandra Hospital, Portsmouth, UK.
Duncan
H D
HD
Timmis
L
L
Green
J R
JR
D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D001944:Breath Tests; D003093:Colitis, Ulcerative / Q000188:drug therapy / Q000382:microbiology*; D003424:Crohn Disease / Q000188:drug therapy / Q000382:microbiology*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D016481:Helicobacter Infections / Q000453:epidemiology*; D016480:Helicobacter pylori; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000188:drug therapy / Q000382:microbiology*; D008297:Male; D019804:Mesalamine / Q000627:therapeutic use; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D012460:Sulfasalazine / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal; D012460:Sulfasalazine; D019804:Mesalamine