title: Helicobacter pylori prevalence and clinical significance in patients with quiescent Crohn's disease.
abstract: BACKGROUND
  Helicobacter pylori (HP) infection is present in about 50% of the global population, and is associated with chronic gastritis, peptic disease and gastric malignancies. HP prevalence in Crohn's disease (CD) patients was shown to be low compared to the general population, and its influence on disease activity is yet to be determined. Our aims were to determine the prevalence of HP in a selected group of CD patients with quiescent disease, and to assess the influence of its eradication on disease activity and endoscopic and laboratory activity measures.
  
  
  METHODS
  Consecutive CD patients with quiescent disease underwent meticulous disease evaluation with MR enterography (MRE), video capsule endoscopy (VCE), CRP, fecal calprotectin and CDAI. All patients were tested for the presence of HP using stool antigen detection kit. Patients infected with HP were offered eradication treatment with sequential therapy. HP eradication was confirmed using urease breath test and stool antigen test. The influence of HP eradication on disease activity was assessed.
  
  
  RESULTS
  Out of 56 patients enrolled, six patients (10.7%) had HP infection. Of them, five patients had gastro- duodenitis per VCE. All HP positive patients were offered eradication treatment and underwent successful eradication. Notably, 23 (50%) of patients had proximal disease per VCE, most of them (78%) were HP negative. CDAI, CRP, fecal calprotectin and VCE Lewis inflammatory score did not change significantly following HP eradication, Gastric findings on VCE were not impacted by HP eradication.
  
  
  CONCLUSIONS
  The prevalence of HP infection in patients with quiescent CD is relatively low. Eradication of the bacteria did not significantly change neither disease activity measures nor the presence of gastro- duodenitis per VCE, suggesting it might be part of proximal CD. The influence of HP on CD activity merits further investigation.
authors.affiliation: Department of Gastroenterology, Sheba Medical Center, Tel Hashomer, Tel Hashomer, Israel. zokadi@gmail.com.|Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. zokadi@gmail.com.
authors.forename: Adi
authors.initials: A
authors.lastname: Lahat
authors.affiliation: Department of Gastroenterology, Sheba Medical Center, Tel Hashomer, Tel Hashomer, Israel.|Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Uri
authors.initials: U
authors.lastname: Kopylov
authors.affiliation: Department of Gastroenterology, Sheba Medical Center, Tel Hashomer, Tel Hashomer, Israel.|Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Sandra
authors.initials: S
authors.lastname: Neuman
authors.affiliation: Department of Gastroenterology, Sheba Medical Center, Tel Hashomer, Tel Hashomer, Israel.|Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Nina
authors.initials: N
authors.lastname: Levhar
authors.affiliation: Department of Gastroenterology, Sheba Medical Center, Tel Hashomer, Tel Hashomer, Israel.|Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Doron
authors.initials: D
authors.lastname: Yablecovitch
authors.affiliation: Department of Gastroenterology, Sheba Medical Center, Tel Hashomer, Tel Hashomer, Israel.|Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Avidan
authors.affiliation: Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.|Edmond and Lily Safra Children's Hospital, Tel Hashomer, Israel.
authors.forename: Batia
authors.initials: B
authors.lastname: Weiss
authors.affiliation: Department of Gastroenterology, Sheba Medical Center, Tel Hashomer, Tel Hashomer, Israel.|Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Shomron
authors.initials: S
authors.lastname: Ben-Horin
authors.affiliation: Department of Gastroenterology, Sheba Medical Center, Tel Hashomer, Tel Hashomer, Israel.|Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Rami
authors.initials: R
authors.lastname: Eliakim
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002097:C-Reactive Protein / Q000032:analysis; D053704:Capsule Endoscopy; D003424:Crohn Disease / Q000000981:diagnostic imaging / Q000382:microbiology* / Q000473:pathology; D060740:Disease Eradication; D005243:Feces / Q000737:chemistry / Q000382:microbiology; D005260:Female; D016481:Helicobacter Infections / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology*; D016480:Helicobacter pylori; D006801:Humans; D039841:Leukocyte L1 Antigen Complex / Q000032:analysis; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012720:Severity of Illness Index
chemical_list: D000900:Anti-Bacterial Agents; D039841:Leukocyte L1 Antigen Complex; D002097:C-Reactive Protein
keywords: Crohn’s disease; Eradication; Helicobacter pylori; Prevalence; Video capsule endoscopy