Diagnosis of Helicobacter pylori Infection in Adults with Intellectual Disability

Abstract

Helicobacter pylori infection is common among adults with intellectual disability. The acceptabilities and accuracies of different diagnostic tests in this population are unknown. We aimed to determine (i) patient acceptability and (ii) performance characteristics of serology, fecal-antigen, and urea breath tests among adults with intellectual disability. One hundred sixty-eight such adults underwent H. pylori testing with serology and fecal-antigen tests, and a portion underwent treatment. One year later, the participants were retested with fecal-antigen, serology, and urea breath tests. The numbers of specimens obtained and difficulties in collection reported by caregivers were noted. Test performance characteristics were assessed among participants and 65 of their caregivers, using serology as the reference. All participants provided at least one specimen, despite reported collection difficulties for 23% of fecal and 27% of blood specimens. Only 25% of the participants provided breath specimens; failure to perform this test was associated with lower intellectual ability and higher maladaptive behavior

Clinical audit of gastrointestinal conditions occurring among adults with Down syndrome attending a specialist clinic

“…Institutional living is a major risk factor for H. pylori infection among people with ID (Wallace, Webb, & Schluter, 2002), and about 90% of residents are likely to have infection. In a previous study, having DS was found not to be an independent risk factor for infection (Wallace, 2002). Only 21% of the study group had a history of institutionalisation, so one might expect the prevalence of H. pylori infection to be only slightly higher than this.…”

“…Genotypic autoimmune-based conditions, such as celiac disease, are also more common in people with DS (3-17% of this group according to various studies, compared to 1% in the general population). Environmentally caused gastrointestinal conditions to which the broader population with intellectual disability, including those with DS, are predisposed, such as Helicobacter pylori (H. pylori) and hepatitis infections (Wallace, 2002), or constipation, comprise another common group. In addition, adults with DS may be at risk of a range of other gastrointestinal conditions through their family history.…”

Major Health Risks in Aging Persons With Intellectual Disabilities: An Overview of Recent Studies

“…Duff, Scheepers, Cooper, Hoghton, and Baddeley (2001) found that among adults with ID in hospitals in England, stomach cancer accounted for 48% of all deaths from cancer, which they attributed to HP. Although effective treatment of HP infections is available, recurrence rates can be quite high ranging from 8% (Clarke et al., 2008) to 21% (Wallace, Schluter, & Webb, 2004).…”

Prevalence of gastrointestinal disorders in adult clients with pervasive developmental disorders

“…Wallace (Wallace et al . 2002, 2003, 2004a,b) studied the diagnosis of Helicobacter pylori infection and its recurrence in adults with ID.…”