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World J Gastroenterol. 2013 Jul 28;19(28):4576-81. doi: 10.3748/wjg.v19.i28.4576.

Helicobacter pylori and Crohn's disease: a retrospective single-center study from China.

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  • 1Department of Gastroenterology, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China.

Abstract

AIM:

To investigate the association between Helicobacter pylori (H. pylori) infection and the prevalence of Crohn's disease (CD).

METHODS:

Subjects were selected from patients admitted the gastrointestinal (GI) department at The First Affiliated Hospital School of Medicine (Zhejiang University) for abdominal pain, hematochezia, diarrhea and other GI symptoms between January 2008 and September 2012. CD was diagnosed by endoscopy and biopsy. H. pylori infection was detected by a (14)C-urea breath test and culturing of the biopsy sample. Demographic, anthropometric and serologic data were collected for each patient. H. pylori infection rate was compared between CD and control groups, followed by a subgroup analysis based on extent and severity of CD. Student's t, Mann-Whiney U, and χ(2) tests were used to analyze the data.

RESULTS:

A total of 447 patients were analyzed, including 229 in the CD group and 248 in the control group. There were no significant differences in age, sex, and rates of hypertension or diabetes. However, the CD group showed significantly higher rates of smoking history (34.9% vs 18.1%), alcohol intake (17.4% vs 8.1%), white blood cell count (9.7 ± 2.9 × 10(9)/L vs 4.3 ± 0.9 × 10(9)/L), and C-reactive protein (36.3 ± 20.8 mg/L vs 5.5 ± 2.3 mg/L) but lower body mass index (24.5 ± 2.0 kg/m(2) vs 26.0 ± 2.2 kg/m(2)) than the control group. The H. pylori infection rate in the CD group was 27.1%, significantly lower than that of 47.9% in the control group. Furthermore, the H. pylori infection rates in patients with colonic, small intestine, ileocolonic and extensive CD were 31.1%, 28.9%, 26.8% and 25.9% respectively, all of which were significantly lower than in the control group. Finally, the H. pylori infection rates in patients with remission, moderate and severe CD were 34.3%, 30.7% and 22.0% respectively, which were also significantly lower than in the control group.

CONCLUSION:

Lower H. pylori infection in CD patients suggests a correlation between bacterial infection and CD, suggesting caution when considering H. pylori eradication in CD patients.

KEYWORDS:

Bacteria; Biopsy; Crohn’s disease; Helicobacter pylori; Inflammatory bowel disease; Pathogenesis; Urea breath test

PMID:
23901235
PMCID:
PMC3725384
DOI:
10.3748/wjg.v19.i28.4576
[PubMed - indexed for MEDLINE]
Free PMC Article
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