Lower Prevalence of Helicobacter pylori Infection in Patients With Inflammatory Bowel Disease But Not With Chronic Obstructive Pulmonary Disease – Antibiotic Use in the History Does Not Play a Significant Role

Pajor, László; Schandl, László; Orosz, Zsuzsa; Magyar, T; Tulassay, Zsolt

doi:10.1111/j.1083-4389.2004.00223.x

Cited by 46 publications

(45 citation statements)

References 12 publications

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“…However, neither salazopyrine nor the other 5-ASA dr ugs used in IBD reach the concentrations required in the corpus and antrum of the stomach to effect H pylori eradication. In addition, studies of IBD patients and disease control groups including patients with COPD [28] , indicate that the H pylori rates in those individuals exposed to multiple antibiotics are in fact higher compared to those exposed to either no antibiotics or fewer courses.…”

Section: H Pylori Exposurementioning

confidence: 99%

Hygiene hypothesis in inflammatory bowel disease: A critical review of the literature

Koloski¹,

Bret²,

Radford‐Smith³

2008

WJG

190

117

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The hygiene hypothesis is thought to be a significant contributor to the growing incidence of inflammatory bowel disease (IBD) around the world, although the evidence for specific factors that underlie the hygiene hypothesis in IBD is unclear. We aimed to systematically review the literature to determine which hygiene-related factors are associated with the development of IBD. Publications identified from a broad based MEDLINE and Current Contents search between 1966 and 2007 on key terms relevant to the 'hygiene hypothesis' and IBD including H pylori exposure, helminths, cold chain hypothesis, measles infection and vaccination, antibiotic use, breastfeeding, family size, sibship, urban upbringing, day care attendance and domestic hygiene were reviewed. The literature suggests that the hygiene hypothesis and its association with decreased microbial exposure in childhood probably plays an important role in the development of IBD, although the strength of the supporting data for each of the factors varies considerably. The most promising factors that may potentially be associated with development of IBD include H pylori exposure, helminths, breastfeeding and sibship. However, the vast majority of studies in this area are plagued by serious methodological shortcomings, particularly the reliance on retrospective recall of information making it difficult to truly ascertain the importance of a 'hygiene hypothesis' in IBD. The 'hygiene hypothesis' in IBD is an important area of research that may give clues to the aetiology of this disease. Directions for future research are recommended.

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Section: H Pylori Exposurementioning

confidence: 99%

Hygiene hypothesis in inflammatory bowel disease: A critical review of the literature

Koloski¹,

Bret²,

Radford‐Smith³

2008

WJG

190

117

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“…Several of these later studies further substituted H. pylori serum IgG or IgA serology for the C 13 urea breath test, an accurate test for assessing active (as opposed to past) infection. These studies also unequivocally confirmed a lower prevalence of H. pylori in IBD patients [66,67,68]. Although all early studies were conducted on European populations, in which IBDs are much more common than in other geographical areas of the world, several more recent studies have confirmed the same trends in Asian and American populations [69,70,71].…”

Section: Epidemiological Evidence Suggests An Inverse Association Betmentioning

confidence: 73%

“…The relatively low risk of H. pylori colonization in IBD patients was initially attributed to the previous exposure to antibiotics such as sulfasalazine [63,65]. As the spontaneous eradication of H. pylori through the use of antibiotics was indeed a possible confounding factor in the early studies - IBD patients are commonly treated with broad-spectrum antibiotics - control groups that had also received antibiotic treatment for conditions such as COPD, and IBD patients that had been treated exclusively with drugs other than antibiotics, were enrolled in several later, more sophisticated studies [66,67]. Such studies with carefully selected control groups confirmed the lower prevalence of H. pylori infection in IBD patients, irrespective of the treatments they received [66,67].…”

Section: Epidemiological Evidence Suggests An Inverse Association Betmentioning

confidence: 99%

“…As the spontaneous eradication of H. pylori through the use of antibiotics was indeed a possible confounding factor in the early studies - IBD patients are commonly treated with broad-spectrum antibiotics - control groups that had also received antibiotic treatment for conditions such as COPD, and IBD patients that had been treated exclusively with drugs other than antibiotics, were enrolled in several later, more sophisticated studies [66,67]. Such studies with carefully selected control groups confirmed the lower prevalence of H. pylori infection in IBD patients, irrespective of the treatments they received [66,67]. Several of these later studies further substituted H. pylori serum IgG or IgA serology for the C 13 urea breath test, an accurate test for assessing active (as opposed to past) infection.…”

Section: Epidemiological Evidence Suggests An Inverse Association Betmentioning

confidence: 99%

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Helicobacter pylori: Does Gastritis Prevent Colitis?

Arnold¹,

Müller²

2016

Inflamm Intest Dis

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Background: Since its discovery in the early 1980s, Helicobacter pylori has been linked to a variety of gastric and extragastric diseases. Chronic infection with H. pylori causes histologically evident gastritis in all colonized individuals and is the predominant risk factor for gastric and duodenal ulcers as well as gastric adenocarcinoma. However, increasingly robust experimental and epidemiological evidence suggests that H. pylori may at the same time be beneficial to its carriers, as it efficiently prevents allergic disorders and chronic inflammatory conditions. The purpose of this review is to summarize and document the latest evidence for a possible inverse association of H. pylori infection status and the risk of inflammatory bowel disease (IBD), as provided in both experimental and human observational studies. The pathogenesis of IBDs, the available mouse models for these diseases and the dual role of H. pylori in health and disease are presented in dedicated chapters. Summary and Key Messages: Almost all available epidemiological data suggest that H. pylori infection is inversely associated with both Crohn's disease (CD) and ulcerative colitis in European, Asian as well as American populations; large meta-analyses reviewing 30 original articles or more document that this inverse association is especially strong in CD patients and in children and young adults. Experimental data available from various mouse models of IBD confirm that live H. pylori infection as well as treatment with immunomodulatory molecules of H. pylori reduce clinical and histopathological IBD symptoms. Various proposed mechanisms involving the tolerization of dendritic cells, the production of protective cytokines and the preferential induction and differentiation of regulatory T-cells are presented. The implications of the beneficial aspects of the Helicobacter-host interaction for H. pylori eradication decisions, as well as potential new therapeutic options in the treatment of IBD are discussed in this review.

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“…Pronai et al compared the HP infection rate between CD patients and chronic obstructive pulmonary disease (COPD) patients in two agematched control groups to evaluate the prevalence of HP infection and the influence of antibiotics in these patients. They found that the prevalence of HP infection was lower than that in the control group and that the administration of antibiotics did not affect the HP infection rate [47]. Thus far, the relationship between CD and HP remains controversial, and further study is needed to analyze the issue.…”

Section: Gastric Lesionsmentioning

confidence: 99%

The endoscopic findings of the upper gastrointestinal tract in patients with Crohn’s disease

Nomura

Moriichi

Fujiya

et al. 2017

Clin J Gastroenterol

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Crohn's disease (CD) is a type of chronic inflammatory bowel disease (IBD) associated with ulceration, and the main foci of the inflammation in CD patients are typically the terminal ileum and colon. However, in the upper gastrointestinal tract (GIT), including the esophagus, stomach and duodenum, inflammatory lesions are also detected as well, with a relatively high frequency (30-75%). Recent advances in imaging modalities, including endoscopy, have aided in the diagnosis of CD. Various lesions, including aphtha, erosion, ulcers, bamboojoint-like appearance and notch-like appearance, are detected in the upper GI of CD patients. Of these lesions, the bamboo-joint-like appearance in the gastric cardiac region and notch-like appearance in the second portion of the duodenum are highly specific for CD, regardless of the disease activity at other sites. These two findings, particularly a bamboo-joint-like appearance, have therefore been considered as potential biomarkers for CD. Although proton pump inhibitors (PPIs) are administered as an initial treatment for upper GIT lesions of CD, the efficacy of this treatment remains controversial. The administration of mesalazine, steroids, immunosuppressant and biologic agents is expected to be effective for treating such lesions.

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Lower Prevalence of Helicobacter pylori Infection in Patients With Inflammatory Bowel Disease But Not With Chronic Obstructive Pulmonary Disease – Antibiotic Use in the History Does Not Play a Significant Role

Cited by 46 publications

References 12 publications

Hygiene hypothesis in inflammatory bowel disease: A critical review of the literature

Hygiene hypothesis in inflammatory bowel disease: A critical review of the literature

<b><i>Helicobacter pylori</i></b>: Does Gastritis Prevent Colitis?

The endoscopic findings of the upper gastrointestinal tract in patients with Crohn’s disease

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