CAMPYLOBACTER PYLORI ASSOCIATED GASTRITIS IN PATIENTS WITH RHEUMATOID ARTHRITIS TAKING NONSTEROIDAL ANTI-INFLAMMATORY DRUGS

Abstract

Fifty-two patients with rheumatoid arthritis taking nonsteroidal anti-inflammatory drugs were studied in order to assess the carriage rate of Campylobacter pylori (C. pylori) with reference to dyspeptic symptoms, endoscopic appearance and antral histology. All patients were interviewed using a standard gastrointestinal symptom scoring questionnaire and underwent endoscopy at which two antral biopsies were obtained. Sections were examined for the presence and severity of gastritis and of C. pylori. Forty-four of 52 patients (85%) had histological evidence of gastritis. Twenty-six of 44 (59%) patients with gastritis were positive for C. pylori. Twenty-six of 28 patients with 'active' (polymorph infiltration) chronic gastritis were positive for C. pylori (p less than 0.002). Sixteen of 26 bacteria-positive patients had gastrointestinal symptoms compared with eight of 26 bacteria-negative patients (p less than 0.05) and this may have therapeutic implications. There was no correlation between the presence of organisms and the appearances at endoscopy.

Omeprazole and sucralfate in the treatment of NSAID‐induced gastric and duodenal ulcer

“…Some considerations emerge from our results. Fifty‐seven per cent of the patients studied were infected with H. pylori , which is not significantly different from the age‐adjusted rate in a control population in a Western country and is consistent with previous studies in rheumatoid arthritis 25 and in arthritics of different aetiologies 26 . The prevalence of infection is superior to that observed in an acute study by Lanza et al ., 27 but is in line with Kim and Graham (50% of positivity for anti H. pylori IgG) 28 and Shalcross et al .…”

Gastrointestinal disorder and Helicobacter pylori infection in patients with rheumatoid arthritis

“…15 About 70%-80% of Japanese people who are over 40 years old are infected with H. pylori. 16 Upadhyay et al 17 and Goggin et al 18 reported that 50% of patients with RA were infected by H. pylori, and the prevalence was similar to that expected for an age-matched population. On the other hand, Caselli et al 19 reported a low prevalence of H. pylori infection, and concluded that this was caused by the use of NSAIDs.…”

Campylobacter-Like Organisms, Nonsteroidal Anti-Inflammatory Drugs and Gastric Lesions in Patients with Rheumatoid Arthritis

“…Upadhyay et al [3] reported that C. pylori is a common finding in RA patients using NSAIDs: these authors. however, did not say which NSAIDs were used.…”

“…On the other hand, although Campylobacter pylori has been closely associated with active chronic gastritis and peptic ulceration, Mar shall et al [2] found that, among gastric ulcer patients without either C. pylori or antral gastritis, a very' high percentage was using NSAIDs. A recent paper by Upadhyay et al [3] suggests that C. pylori is commonly found in RA patients taking NSAIDs. In a prelimi nary study, however, we found that the pres ence of campylobacter-Iike organisms (CLO) was significantly lower in RA NSAIDtreated patients in comparison with a histo logically comparable control group [4].…”