Prevalence of Helicobacter pylori in NSAID users with gastric ulcer.
OBJECTIVE
Regarding the interaction of Helicobacter pylori and non-steroidal anti-inflammatory drugs (NSAIDs), we cannot accept unanimous conclusions in inducing gastric ulcer. We therefore evaluated the role of Helicobacter pylori and NSAIDs in inducing gastric ulcer.


METHODS
Dyspeptic patients receiving NSAIDs underwent endoscopic examination. Gastric ulcer formation and H. pylori status were investigated. Biopsy specimens from the antrum and lower body of the stomach were prepared for the rapid urease test and pathological evaluation. Anti-H. pylori antibody was measured by enzyme-linked immunosorbent assay.


RESULTS
Two hundred and twenty-six patients receiving NSAIDs (220 chronic and six on-demand users) underwent gastrofibrescopic examination. There were 110 patients with gastric ulcer and 111 non-ulcer patients with gastritis. The remaining five patients had neither. NSAID users with gastric ulcer showed a low prevalence of H. pylori compared with those without them [55/110 (50.0%) vs 79/111 (71.2%), P < 0.01]. The same tendency was seen when patients receiving low-dose aspirin and those with rheumatoid arthritis were analysed separately [13/29 (44.8%) vs 50/62 (80.6%), P < 0.01, and 11/33 (33.3%) vs 16/26 (61.5%), P < 0.06 with Yates' correction, respectively].


CONCLUSIONS
Helicobacter pylori infection appeared to be a risk factor for developing gastritis, but we found no evidence that it increases gastric ulcer formation in NSAID users with dyspepsia.
Department of Internal Medicine I, Nihon University School of Medicine, Oyaguchi-Kamimachi, Itabashi 173-8610, Tokyo, Japan. m-2000@mbk.sphere.ne.jp
Y
Y
Matsukawa
M
M
Aoki
S
S
Nishinarita
S
S
Sawada
T
T
Horie
K
K
Kato
Y
Y
Kawamura
F
F
Kawamura
Y
Y
Arakawa
H
H
Kurosaka
K
K
Morita
E
E
Ohtsuka
M
M
Oribe
M
M
Nakano
Y
Y
Kitami
D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects* / Q000627:therapeutic use; D000907:Antibodies, Bacterial / Q000097:blood; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000188:drug therapy; D016009:Chi-Square Distribution; D005260:Female; D005756:Gastritis / Q000150:complications / Q000382:microbiology; D016481:Helicobacter Infections / Q000150:complications*; D016480:Helicobacter pylori / Q000276:immunology; D006801:Humans; D008297:Male; D008875:Middle Aged; D013276:Stomach Ulcer / Q000139:chemically induced / Q000209:etiology* / Q000382:microbiology
D000894:Anti-Inflammatory Agents, Non-Steroidal; D000907:Antibodies, Bacterial