title: Cystic fibrosis, gastroduodenal inflammation, duodenal ulcer, and H. pylori infection: the "cystic fibrosis paradox" revisited.
abstract: BACKGROUND
  In cystic fibrosis (CF) patients a duodenal impaired bicarbonate secretion and unbuffered gastric acid are always described and the development of duodenal ulceration is uncommon (CF paradox). Helicobacter pylori (HP) infection is the main cause for duodenal ulceration and its prevalence in CF patients is controversial.
  
  
  OBJECTIVE
  The objective of this study is to evaluate HP prevalence, gastric histology, and duodenal ulceration in adult FC patients.
  
  
  METHODS
  32 adult CF patients were submitted to (13)C-urea breath test and serum immunoblotting test for HP diagnosis. Among them, 20 patients were submitted to endoscopy.
  
  
  RESULTS
  19/32 (68%) patients showed positive serology. Endoscopy showed erosive duodenitis (15%), and duodenal ulcer scar in 10%. On duodenal histology, 94.5%, showed active inflammation and 66.7% gastric metaplasia.
  
  
  CONCLUSIONS
  HP infection prevalence in adult CF patients was similar to that of general Brazilian population. CF patients have all the duodenal spectrum of alterations, including duodenal ulcer. CF paradox may not exist.
authors.affiliation: Instituto Alfa de Gastroenterologia, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
authors.forename: Ana Flávia Passos
authors.initials: AF
authors.lastname: Ramos
authors.forename: Marcelo Bicalho
authors.initials: MB
authors.lastname: de Fuccio
authors.forename: Luciana Dias
authors.initials: LD
authors.lastname: Moretzsohn
authors.forename: Alfredo José Afonso
authors.initials: AJ
authors.lastname: Barbosa
authors.forename: Maria do Carmo Friche
authors.initials: Mdo C
authors.lastname: Passos
authors.forename: Rhaissa Said
authors.initials: RS
authors.lastname: Carvalho
authors.forename: Luiz Gonzaga Vaz
authors.initials: LG
authors.lastname: Coelho
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003550:Cystic Fibrosis / Q000150:complications*; D004381:Duodenal Ulcer / Q000209:etiology* / Q000473:pathology; D004382:Duodenitis / Q000209:etiology* / Q000473:pathology; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005756:Gastritis / Q000209:etiology* / Q000473:pathology; D016481:Helicobacter Infections / Q000150:complications* / Q000453:epidemiology; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D055815:Young Adult