Is There a Link Between H. Pylori and the Epidemiology of Crohn’s Disease?

Abstract

Our data demonstrate a significant inverse association between geographic distribution of H. pylori and CD. Thus, it is highly unlikely that the findings of previous case control studies were simply due to confounding factors such as concomitant antibiotic use in CD patients.

Epidemiological and Clinical-Pathological Aspects of Helicobacter pylori Infection in Brazilian Children and Adults

“…H. pylori prevalence estimates show a great variation globally, with rates varying from 15.1% in developed countries (Australia) to 87.7% in developing countries (Nigeria) [ 1 , 18 ]. In addition, there are great regional variations within the same country [ 1 , 19 ].…”

“…For 2015, it was estimated that approximately 4.4 billion individuals were infected by H pylori worldwide [ 1 ]. However, in the last decades, due to improvements in sanitation, health, socio-cultural conditions, and eradication methods, a decline of the H. pylori infection prevalence has been observed in different countries, concomitant with a decrease of the peptic ulcer disease and gastric cancer [ 1 , 18 ]. These findings reinforce the idea that bacterial eradication in areas of high gastric cancer prevalence reduces the risk of this neoplasm [ 2 ].…”

Association of Helicobacter pylori and Crohn’s Disease Incidence: An Inversion Reaction?

“…In the current issue of Digestive Diseases and Sciences, an interesting article by Shah et al [4] addresses this topic. In the article entitled ''Is there a link between H. pylori and the epidemiology of Crohn's disease,'' the authors studied associations between H. pylori and Crohn's disease at an ecological level.…”

“…In several geographical settings, these studies all concluded that H. pylori and Crohn's disease are inversely correlated (see reference list in [4]). …”

“…Other possible biases and confounders include exposure of Crohn's patients to other medical treatments that affect H. pylori, or just simply publication biases that skew the data. Of course, any biased conclusions would affect metaanalyses such as the ones listed in [4].…”