Helicobacter pylori: A risk and severity factor of nonsteroidal anti-inflammatory drug induced gastropathy

Abstract

This prospective study aimed to determine the prevalence of Helicobacter pylon infection in relation to the occurrence and severity of NSAIDs induced gastropathy. A total of 111 patients were studied - 66 were taking NSAIDs and 45 were control patients. All patients underwent endoscopy during which antral biopsy specimens were taken to determine H pylon status (Gram and Giemsa staining, urease test, and cultures). The NSAID group comprised: group I, patients without mucosal damage (n=28); group II, patients with gastropathy (n= 26); and group III, patients with bleeding associated with NSAID induced gastropathy (n= 12). Control patients had neither dyspeptic symptoms nor endoscopic lesions. There were no differences in age, sex ratio, or presence of H pylon (26% v 24%) between the NSAID and the control groups. Among patients taking NSAIDs, H pylon infection was more frequently (p<0·02) diagnosed in those who presented with gastropathy (groups II and III: 37%) than in those without lesions (group I: 11%). The frequency of H pylori infection increased significantly with the severity of gastropathy (group I= 11%; group II=31%; group III=50%; p<0·03). Hpylori infection was associated with chronic active gastritis (group I=21%; group II=35%; group III=67%; p<0·05). These data suggest that H pylon may be a risk factor of NSAID induced gastropathy.