Association Between H. pylori Infection and Colorectal Polyps: A Meta-Analysis of Observational Studies

Lu, Depeng; Wang, Mingyu; Ke, Xia; Wang, Qiangwu; Wang, Jianchao; Li, Dapeng; Wang, Meng; Wang, Qizhi

doi:10.3389/fmed.2021.706036

Cited by 8 publications

(9 citation statements)

References 49 publications

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“…1 ). As previous analyses [ 4 ] showed a distinct behavior of traditional neoplasia and serrated neoplasia, we evaluated the association between H. pylori + and serrated lesions separately. We found no association between serrated neoplasia and H. pylori + (aOR 1.22; 95% CI: 0.66–2.27; p = 0.53).…”

Section: Resultsmentioning

confidence: 99%

“…Our study is in line with previous analyses suggesting an association between H. pylori + and CRN. Lu et al [ 4 ] reported an association between H. pylori + and CRN in a meta-analysis including more than 300,000 patients. Of note, H. pylori + status was associated not only with the diagnosis of any CRN but also with advanced neoplasia.…”

Section: Discussionmentioning

confidence: 99%

“…H. pylori is recognized as a carcinogen and therefore eradication by antibiotic chemotherapy is recommended in most clinical situations when H. pylori + is diagnosed [ 3 ]. There is evidence from epidemiological studies and meta-analyses that H. pylori infection is associated with an increased likelihood of occurrence of CRC [ 4 ]. Direct stimulation of the mucosa by H. pylori , alteration of the gut microbiome by H. pylori , and low-grade systemic inflammation by H. pylori have been postulated as possible pathologic mechanisms for this association [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

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The Association between Helicobacter pylori and Colorectal Neoplasia

Wernly¹,

Semmler²,

Flamm³

et al. 2022

Med Princ Pract

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Objectives: Both Helicobacter pylori (H. pylori) and colorectal neoplasia (CRN) are frequent entities in gastroenterology. Epidemiological data suggest an association between H. pylori positivity (H. pylori +) and CRN, whereas pathophysiologic considerations substantiate a possible causal relationship. However, the relationship between CRN and H. pylori+ may also be mediated by shared risk factors. Therefore, the aim of this cross-sectional study was to evaluate a possible independent relationship between H.pylori and CRN in a Central European cohort. Methods: We included 5,707 asymptomatic patients in this study. All patients underwent screening colonoscopy and upper gastrointestinal endoscopy. We assessed the association between any and advanced CRN and H. pylori + using multilevel logistic regression. We adjusted for age, sex, a positive family history of colorectal cancer and cardiovascular risk. Results: 1,082 patients (19%) were H. pylori + and 4,625 (81%) H. pylori -. Both patients with CRN and H. pylori had more cardiometabolic risk factors. In both univariate (aOR 1.20 1.10-1.31; p<0.001) and multivariable analysis (aOR 1.20 1.08-1.32; p<0.001), H. pylori + was associated with the diagnosis of any CRN. However, we found that H. pylori + was associated with the presence of advanced CRN (aOR 1.26; 0.96-1.64; p=0.10) only in trend. Conclusions: We found a clustered co-occurrence of CRN and H. pylori. This association persisted after correction for shared cardiometabolic risk factors. We think that our analysis emphasizes the clinical value of H. pylori eradication. Whether "test and treat" H. pylori is warranted to prevent CRN remains unclear but is at least a possibility given the simplicity of "test and treat".

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Association between Helicobacter pylori and Colorectal Neoplasia

Wernly¹,

Semmler²,

Flamm³

et al. 2022

Med Princ Pract

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“…Several studies have shown that Hp infection is a risk factor for colorectal polyps [ 12 , 17 ]. Hp causes hyperplasia of the intestinal mucosa by increasing the levels of gastrin, which can lead to the development of intestinal polyps [ 11 , 18 , 19 ]. However, some studies contradict this hypothesis [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

“…Interestingly a report suggests an association between Hp infection and colorectal polyps [ 10 ]. Hp infection promotes the secretion of gastric acid and causes colorectal polyps [ 11 , 12 ]. Whether the correlation between Hp infection and colorectal polyps is mediated by Hp-associated atrophic gastritis is yet to be established.…”

Section: Introductionmentioning

confidence: 99%

Atrophic gastritis rather than Helicobacter pylori infection can be an independent risk factor of colorectal polyps: a retrospective study in China

Shao-hua,

Lin-lin,

Shen

et al. 2023

BMC Gastroenterol

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Background Colonoscopy is considered the most effective screening method for colorectal polyps. However, the longevity and complexity of the procedure makes it less desirable to screen for colorectal polyps in the general population. Therefore, it is essential to identify other independent risk factors. In this study, we explored the link between Hp infection, atrophic gastritis, and colorectal polyps to identify a new potential risk factors of colorectal polyps. Methods In this study, atrophic gastritis and intestinal polyps were diagnosed by endoscopy and pathology. All the 792 patients in this retrospective study were divided into sub-groups based on the presence of colorectal polyps. The correlation between polyps and atrophic gastritis was analyzed using the chi-square test and Kruskal-Wallis test. The receiver operating characteristic (ROC) curve was used to compare the predictive value for colorectal polyps between Hp infection and atrophic gastritis. Binary logistic regression was utilized to identify independent risk factors for colorectal polyps. Results Patients with colorectal polyps were primarily male with advanced age, and the number of patients with colorectal polyps had a higher association with smoking, alcohol drinking, and Hp infection than the control group. A positive correlation between the number of colorectal polyps and the severity of atrophic gastritis was observed. ROC analysis showed that atrophic gastritis was a better risk factors for colorectal polyps. Multivariate analysis identified atrophic gastritis as an independent risk factor for colorectal polyps (OR 2.294; 95% CI 1.597–3.296). Conclusions Atrophic gastritis confirmed could be an independent risk factors for colorectal polyps.

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Helicobacter pylori infection and small intestinal bacterial overgrowth: a systematic review and meta-analysis

Liao,

Su,

2023

BMC Microbiol

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Background There is a link between Helicobacter pylori (HP) infection and small intestinal bacterial overgrowth (SIBO) with nonspecific digestive symptoms. Nonetheless, whether HP infection is associated with SIBO in adults remains unclear. Based on a meta-analysis, we evaluated this relationship. Results Observational studies relevant to our research were identified by searching PubMed, Embase, the Cochrane Library, and the Web of Science. We evaluated between-study heterogeneity using the Cochrane Q test and estimated the I2 statistic. Random-effects models were used when significant heterogeneity was observed; otherwise, fixed-effects models were used. Ten datasets from eight studies, including 874 patients, were involved in the meta-analysis. It was shown that HP infection was related to a higher odds of SIBO (odds ratio [OR]: 1.82, 95% confidence interval: 1.29 to 2.58, p < 0.001) with mild heterogeneity (p for Cochrane Q test = 0.11, I2 = 7%). Subgroup analyses showed that HP infection was related to SIBO in young patients (mean age < 48 years, OR: 2.68, 95% CI: 1.67 to 4.28, p < 0.001; I2 = 15%) but not in older patients (mean age ≥ 48 years, OR: 1.15, 95% CI: 0.69 to 1.92, p < 0.60; I2 = 1%; p for subgroup difference = 0.02). Subgroup analyses further indicated that the association was not significantly affected by the country of study, comorbidities, exposure to proton pump inhibitors, or methods of evaluating HP infection and SIBO. Conclusions HP infection may be related to SIBO in adults, which supports the detection of SIBO in patients with digestive symptoms and HP infection.

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Association Between H. pylori Infection and Colorectal Polyps: A Meta-Analysis of Observational Studies

Cited by 8 publications

References 49 publications

The Association between Helicobacter pylori and Colorectal Neoplasia

The Association between Helicobacter pylori and Colorectal Neoplasia

Atrophic gastritis rather than Helicobacter pylori infection can be an independent risk factor of colorectal polyps: a retrospective study in China

Helicobacter pylori infection and small intestinal bacterial overgrowth: a systematic review and meta-analysis

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